Thrombosis research最新文献_第2页

Monocyte depletion reduces late experimental post-thrombotic fibrotic injury in a stasis mouse model 单核细胞耗竭减少实验性晚期血栓后纤维化损伤在停滞小鼠模型

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-22 DOI: 10.1016/j.thromres.2026.109595

Mattea Pellerito , Abigail R. Dowling , Catherine E. Luke , Qing Cai , Antonio M. Pellerito , Andrew Quang , Lonnie Shea , Farouc Jaffer , Andrea Obi , Peter K. Henke

Background

Post thrombotic syndrome is a fibrotic disease related to inflammation resolution. There are no direct therapies that can ameliorate this disease. Monocyte/macrophages (Mo/MØ) are the primary leukocyte involved with later venous resolution, and likely direct vein wall responses and healing. Herein, we explored the vein wall response with Mo/MØ depletion by two methods.

Methods

Using two mouse models of venous thrombosis (VT), complete stasis and a flow restricted model, Mo/MØ depletion was accomplished using CD11b-DTR mice administered diphtheria toxin, and clodronate micelle administration in wild type mice. Tissue assays for structural histology, immunohistochemistry and western blotting were performed.

Results

Mo/MØ depletion resulted in significantly less vein wall fibrotic thickness, in the stasis model at day 14 in both the CD11b-DTR mice and those receiving clodronate micelles. No significant effect of Mo/MØ depletion was observed in the flow restricted VT model. The decrease in vein wall fibrosis was associated with fewer DDR2+ vein wall cells in the CD11b-DTR mice, but no difference in endothelial luminal coverage. Decreased cytokine and growth factor expression of IL-6, FSP-1, and VEGFa were associated with Mo/MØ depletion. Lastly, PMN depletion was associated with increased proinflammatory Mo/MØ, and a trend towards increased vein wall fibrosis as compared with controls.

Conclusion

Mo/MØ direct the post VT late fibrotic response, possibly by affecting fibroblasts and inflammatory cytokine expression. This effect was only found with the complete stasis model and is consistent with worsened PTS in humans with complete venous obstruction.

背景：血栓形成后综合征是一种与炎症消退相关的纤维化疾病。目前还没有直接的治疗方法可以改善这种疾病。单核细胞/巨噬细胞（Mo/MØ）是参与后期静脉溶解的主要白细胞，可能直接静脉壁反应和愈合。在此，我们通过两种方法探讨了Mo/MØ耗尽时的静脉壁响应。方法采用两种小鼠静脉血栓形成模型、完全停滞模型和血流受限模型，采用CD11b-DTR小鼠给予白喉毒素和氯膦酸盐胶束给予野生型小鼠，完成Mo/MØ的消耗。进行组织结构组织学、免疫组织化学和免疫印迹分析。结果smo /MØ缺失导致CD11b-DTR小鼠和接受氯膦酸胶束治疗的小鼠在第14天的停滞模型中静脉壁纤维化厚度明显减少。在受限流动的VT模型中未观察到Mo/MØ消耗的显著影响。在CD11b-DTR小鼠中，静脉壁纤维化的减少与较少的DDR2+静脉壁细胞有关，但内皮管腔覆盖没有差异。细胞因子和生长因子IL-6、FSP-1和VEGFa表达的降低与Mo/MØ缺失有关。最后，与对照组相比，PMN消耗与促炎Mo/MØ增加以及静脉壁纤维化增加的趋势相关。结论mo /MØ可能通过影响成纤维细胞和炎性细胞因子的表达，直接影响VT后晚期纤维化反应。这种影响仅在完全停滞模型中发现，并且与完全性静脉阻塞患者PTS恶化一致。

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引用次数: 0

Mild hemophilia B in a female with compound heterozygous FIX variants presented with abdominal pain and diagnosed with nutcracker syndrome, and median arcuate ligament syndrome 一名患有复合杂合FIX变异的女性患有轻度血友病B，表现为腹痛，诊断为胡桃钳综合征和正中弓状韧带综合征

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-20 DOI: 10.1016/j.thromres.2026.109594

Davut Ünsal Çapkan , Asmin Çelik , Uğur Gümüş , İbrahim Tayfun Şahiner , Ekrem Ünal

引用次数: 0

Automated thrombin generation assay in patients entering hospital for total hip or knee arthroplasty: A prospective study 全髋关节或膝关节置换术患者自动凝血酶生成测定：一项前瞻性研究。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-19 DOI: 10.1016/j.thromres.2026.109591

Mathias Chea , Eva Nouvellon , Sandrine Alonso , Philippe Marchand , Rémy Coulomb , Pascal Kouyoumdjian , Mikaël Perin , Jeremy Laurent , Thibault Mura , Antonia Perez-Martin , Sylvie Bouvier , Jean-Christophe Gris

引用次数: 0

Perioperative factor XIII and viscoelastic measurements of open compared to minimal invasive major upper gastrointestinal surgery– A prospective observational study 一项前瞻性观察研究：与微创上消化道大手术相比，开放手术围手术期因子XIII和粘弹性测量

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-19 DOI: 10.1016/j.thromres.2026.109592

M. von der Forst , S. Hoewelhaus , L. Gilles , D.D. Uzun , S. Katzenschlager , C. Heim , M. Dietrich , D. Gruneberg , M.A. Weigand , H. Schöchl , F.C.F. Schmitt

Purpose

Acquired Factor XIII (FXIII) deficiency is prevalent in hospitalized or surgical patients, with FXIII activity <70% in over 20% of cases. A decrease in FXIII has been linked with postoperative bleeding, anastomotic insufficiency, and a greater likelihood of requiring reoperation. This study aims to identify patients at increased risk for postoperative complications by comparing open versus minimally invasive pancreatic and esophageal surgery.

Methods

This prospective, monocentric observational study was conducted at Heidelberg University Hospital (Germany). Inclusion criteria consisted of age ≥ 18 years, the ability to provide informed consent, and scheduled esophageal or pancreatic surgery. A coagulation panel was performed preoperatively, directly after surgery and on postoperative day (POD) 1, 2, 3, 4, 7, 10, and 13, along with repeated thromboelastography (ClotPro®) Tests.

Results

Finally, 112 patients were enrolled (n = 77 open and n = 35 minimally invasive). FXIII activity showed a more pronounced decrease in the open surgery group until day 7; in both groups, the lowest FXIII activity occurred between days 4 and 7. There were no significant group differences in readmissions, reoperations, or severe perioperative complications according to the Clavien-Dindo classification.

Conclusion

Open surgery was associated with a significant decline in FXIII activity, with a nadir estimated to occur between POD 4 and 7. FXIII activity also remained significantly reduced until day 7 after surgery. Viscoelastic testing was not able to detect mild acquired FXIII deficiencies. The extent to which routine testing of FXIII activity should be performed prior to reoperation must be evaluated in further studies. German Clinical Trials Register (DRKS00028547, registration date: April 14, 2022).

目的获得性因子XIII （FXIII）缺乏在住院或手术患者中很普遍，超过20%的病例中FXIII活性为70%。FXIII的减少与术后出血、吻合口不全和需要再次手术的可能性增加有关。本研究旨在通过比较开放与微创胰腺和食管手术来确定术后并发症风险增加的患者。方法本前瞻性、单中心观察性研究在德国海德堡大学医院进行。纳入标准包括年龄≥18岁，有能力提供知情同意，并计划进行食管或胰腺手术。术前、术后直接和术后第1、2、3、4、7、10和13天进行凝血检查，同时进行重复血栓弹性成像（ClotPro®）试验。结果最终纳入112例患者，其中开放手术77例，微创手术35例。开放手术组FXIII活性下降更明显，直至第7天；在两组中，FXIII活性最低发生在第4天和第7天。根据Clavien-Dindo分类，两组在再入院、再手术或严重围手术期并发症方面无显著差异。结论开放手术与FXIII活性显著下降相关，最低点估计发生在POD 4和7之间。FXIII活性直到术后第7天仍显著降低。粘弹性试验不能检测到轻度获得性FXIII缺陷。必须在进一步的研究中评估在再手术前应在多大程度上进行FXIII活性常规检测。德国临床试验注册（DRKS00028547，注册日期：2022年4月14日）。

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引用次数: 0

Standard coagulation assays during cardiopulmonary bypass predict post-bypass levels in cardiac surgery 体外循环期间的标准凝血测定可预测心脏手术中体外循环后的血凝水平。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-19 DOI: 10.1016/j.thromres.2026.109593

Victor-Emmanuel Brett , Antoine Beurton , Alexandre Ouattara , Céline Delassasseigne , Christine Mouton

Background

Cardiac surgery with cardiopulmonary bypass (CPB) requires precise hemostasis management to limit postoperative bleeding. Fibrinogen, platelet count, and pro-coagulant factors guide transfusion decisions, yet Clauss fibrinogen measurement during CPB is debated, and prothrombin time (PT) cannot be measured accurately due to interference from high-dose heparin. This study investigated whether intraoperative measurements of fibrinogen, prothrombin (FII), factor V (FV), and platelet obtained during CPB could reliably predict post-CPB values.

Methods

We conducted a single-center, prospective observational study involving 73 adult patients undergoing cardiac surgery with CPB. Blood samples were collected before aortic unclamping and five minutes after completion of protamine administration. Fibrinogen (Clauss method), FII, and FV activities were measured using HemosIL reagents on an ACL TOP analyzer.

Results

Using appropriate reagents, fibrinogen, FII, and FV were reliably measured during CPB, despite high-dose heparin. Strong correlations were observed between intra-CPB and post-CPB values for fibrinogen (r = 0.81), FII (r = 0.78), and FV (r = 0.73), supporting their reliability in anticipating post-bypass coagulation status. ROC curve analyses demonstrated good predictive performance for transfusion-relevant thresholds, with AUCs of 0.93 for platelet count <100 G/L, 0.86 for fibrinogen <1.5 g/L, and 0.84 for FII < 50% activity.

Conclusions

This study showed that fibrinogen and factor II (a surrogate for PT) levels remain consistent between the CPB period and after protamine administration in adult cardiac surgery patients, confirming the reliability of their intraoperative assessment.

背景：心脏手术合并体外循环（CPB）需要精确的止血管理来限制术后出血。纤维蛋白原、血小板计数和促凝因子指导输血决策，但CPB期间的Clauss纤维蛋白原测量存在争议，而且由于高剂量肝素的干扰，凝血酶原时间（PT）无法准确测量。本研究探讨了CPB术中纤维蛋白原、凝血酶原（FII）、V因子（FV）和血小板的测量是否能可靠地预测CPB后的值。方法：我们进行了一项单中心前瞻性观察研究，涉及73例接受心脏手术合并CPB的成年患者。在主动脉开锁前和鱼精蛋白给药结束后5分钟采集血样。在ACL TOP分析仪上使用haemsil试剂测定纤维蛋白原（Clauss法）、FII和FV活性。结果：使用合适的试剂，在CPB期间，尽管使用高剂量肝素，纤维蛋白原、FII和FV的测量是可靠的。纤维蛋白原（r = 0.81）、FII （r = 0.78）和FV （r = 0.73）在cpb内和cpb后的值之间存在很强的相关性，这支持了它们预测搭桥后凝血状态的可靠性。ROC曲线分析显示输血相关阈值具有良好的预测性能，血小板计数的auc为0.93。结论：本研究显示，成人心脏手术患者CPB期和给予鱼精蛋白后，纤维蛋白原和因子II （PT的替代物）水平保持一致，证实了其术中评估的可靠性。

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引用次数: 0

The influence of thrombophilia and low molecular weight heparin on D-Dimer levels in women with high-risk pregnancy 血栓形成和低分子肝素对高危妊娠妇女d -二聚体水平的影响。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-15 DOI: 10.1016/j.thromres.2026.109589

Elisa Frenzel , Maren Keller , Maria Weise , Tristan Klöter , Martin Federbusch , Mitja Heinemann , Michael Metze , Sirak Petros , Christian Pfrepper

Introduction

Pregnancy is a hypercoagulable state that raises the risk of venous thromboembolism VTE), particularly in women with thrombophilia. D-Dimer levels increase during the activation of the coagulation cascade and are used to exclude VTE in non-pregnant women. This study aimed to analyze the influence of thrombophilia and the use of low molecular weight heparin (LMWH) on D-dimer levels in pregnant women.

Methods

We retrospectively analyzed data from pregnant women presenting at the hemostaseology outpatient clinic of the University Hospital of Leipzig between July 2016 and June 2023. The women were seen at intervals of four to six weeks and D-dimer concentrations were measured at every visit.

Results

A total of 301 women were included in the study, of whom 121 were diagnosed with thrombophilia. The concentration of D-dimer increased continuously throughout pregnancy both in women with and without LMWH. Patients diagnosed with thrombophilia had similar D-Dimer levels compared to women without thrombophilia, irrespective of LMWH administration. Women with heterozygous Factor-V-Leiden mutation who did not receive thromboprophylaxis had higher D-Dimer levels during most of their pregnancy than those without thrombophilia. The initiation of LMWH led to a significant reduction of D-dimers in early pregnancy, and patients started on LMWH prophylaxis early in pregnancy had lower D-dimers later in pregnancy.

Conclusion

This is one of the largest studies evaluating D-dimer concentrations in women with high-risk pregnancies. Further studies with clinical endpoints are required to evaluate the role of D-dimers in deciding whether to initiate LMWH prophylaxis.

妊娠是一种高凝状态，可增加静脉血栓栓塞（VTE）的风险，特别是对血栓患者。d -二聚体水平在凝血级联激活期间增加，用于排除非孕妇的静脉血栓栓塞。本研究旨在分析血栓形成和使用低分子肝素（LMWH）对孕妇d -二聚体水平的影响。方法：回顾性分析2016年7月至2023年6月在莱比锡大学医院止血门诊就诊的孕妇资料。研究人员每隔4至6周对这些女性进行一次观察，并在每次随访时测量d -二聚体的浓度。结果：共有301名女性被纳入研究，其中121名被诊断为血栓形成。d -二聚体的浓度在妊娠期间持续升高，无论有无低分子肝素。与没有血栓形成的女性相比，诊断为血栓形成患者的d -二聚体水平相似，与低分子肝素治疗无关。患有杂合子因子- v - leiden突变而未接受血栓预防治疗的妇女在大多数怀孕期间的d -二聚体水平高于没有血栓的妇女。低分子肝素的启动导致妊娠早期d -二聚体显著降低，妊娠早期开始低分子肝素预防的患者妊娠后期d -二聚体较低。结论：这是评估高危妊娠妇女d -二聚体浓度的最大研究之一。需要有临床终点的进一步研究来评估d -二聚体在决定是否开始低分子肝素预防方面的作用。

{"title":"The influence of thrombophilia and low molecular weight heparin on D-Dimer levels in women with high-risk pregnancy","authors":"Elisa Frenzel , Maren Keller , Maria Weise , Tristan Klöter , Martin Federbusch , Mitja Heinemann , Michael Metze , Sirak Petros , Christian Pfrepper","doi":"10.1016/j.thromres.2026.109589","DOIUrl":"10.1016/j.thromres.2026.109589","url":null,"abstract":"<div><h3>Introduction</h3><div>Pregnancy is a hypercoagulable state that raises the risk of venous thromboembolism VTE), particularly in women with thrombophilia. D-Dimer levels increase during the activation of the coagulation cascade and are used to exclude VTE in non-pregnant women. This study aimed to analyze the influence of thrombophilia and the use of low molecular weight heparin (LMWH) on D-dimer levels in pregnant women.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed data from pregnant women presenting at the hemostaseology outpatient clinic of the University Hospital of Leipzig between July 2016 and June 2023. The women were seen at intervals of four to six weeks and D-dimer concentrations were measured at every visit.</div></div><div><h3>Results</h3><div>A total of 301 women were included in the study, of whom 121 were diagnosed with thrombophilia. The concentration of D-dimer increased continuously throughout pregnancy both in women with and without LMWH. Patients diagnosed with thrombophilia had similar D-Dimer levels compared to women without thrombophilia, irrespective of LMWH administration. Women with heterozygous Factor-V-Leiden mutation who did not receive thromboprophylaxis had higher D-Dimer levels during most of their pregnancy than those without thrombophilia. The initiation of LMWH led to a significant reduction of D-dimers in early pregnancy, and patients started on LMWH prophylaxis early in pregnancy had lower D-dimers later in pregnancy.</div></div><div><h3>Conclusion</h3><div>This is one of the largest studies evaluating D-dimer concentrations in women with high-risk pregnancies. Further studies with clinical endpoints are required to evaluate the role of D-dimers in deciding whether to initiate LMWH prophylaxis.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"258 ","pages":"Article 109589"},"PeriodicalIF":3.4,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brazilian Registry of Thrombotic Thrombocytopenic Purpura: A prospective cohort study of diagnosis, management and outcomes in Brazil 巴西血栓性血小板减少性紫癜登记：巴西诊断、管理和结果的前瞻性队列研究

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-15 DOI: 10.1016/j.thromres.2026.109590

Thaís D.R. Nóbrega , Tiago Boechat , Denys E. Fujimoto , Sibia S. Marcondes , Silvia Bueno , Suzanna A. Tavares , Alessandra Prezotti , Juliana S.M. Duarte , Fabiana C.C. Piassi , Lucas Cesped , Erica Okazaki , Bianca Stefanello , Carolina Costa-Lima , Paula R. Villaça , Fernanda A. Orsi

Most data supporting current knowledge about thrombotic thrombocytopenic purpura (TTP) come from high-income regions, while little is known about treatment access and prognosis in low- and middle-income countries. To address this gap, we conducted a multicenter prospective study that included 85 TTP patients in Brazil between 2018 and 2024, with a 12-month follow-up. The median age was 37 years (IQR 27–45) and 76% were female. The median PLASMIC score was six (IQR 6.0–7.0), and ADAMTS13 activity was tested in 62.4% of patients (all <10%). The median time from symptom onset to hospital admission was 8 days. Neurological manifestations were the most frequent (75.3%), followed by bleeding symptoms (58.8%) and abdominal pain (32.9%). Seventy-four patients (87.1%) underwent therapeutic plasma exchange (TPE), which was initiated within one day of admission (IQR 1–2). Corticosteroids were administered in 95.3% and rituximab in 56.5% of patients. Twenty-three patients (27.1%) required advanced life support and 13 (15.3%) died during hospitalization. In-hospital mortality was associated with older age and hemodynamic instability upon admission. Among survivors, 26% experienced exacerbation or relapse, and 22.4% developed chronic sequelae, mostly neurological and psychiatric symptoms. Rituximab use was protective against TTP relapses. In conclusion, TTP mortality in Brazil is higher than that observed in recent cohorts. TTP diagnosis and treatment in the country are delayed and outdated, negatively affecting disease prognosis. Ensuring rapid diagnosis and the availability of TPE and rituximab, a cost-effective treatment strategy, is essential for improving outcomes and reducing morbidity, including in low- and middle-income countries.

支持目前关于血栓性血小板减少性紫癜（TTP）知识的大多数数据来自高收入地区，而对低收入和中等收入国家的治疗可及性和预后知之甚少。为了解决这一差距，我们进行了一项多中心前瞻性研究，包括2018年至2024年间巴西的85名TTP患者，随访12个月。中位年龄为37岁（IQR 27-45）， 76%为女性。血浆评分中位数为6分（IQR 6.0-7.0）， 62.4%的患者（均为10%）检测了ADAMTS13活性。从症状出现到住院的中位时间为8天。以神经系统症状最为常见（75.3%），其次为出血症状（58.8%）和腹痛（32.9%）。74例患者（87.1%）接受了治疗性血浆置换（TPE），并在入院1天内开始（IQR 1-2）。95.3%的患者使用皮质类固醇，56.5%的患者使用利妥昔单抗。23例（27.1%）患者需要高级生命支持，13例（15.3%）患者在住院期间死亡。住院死亡率与年龄和入院时血流动力学不稳定有关。在幸存者中，26%的人病情加重或复发，22.4%的人出现慢性后遗症，主要是神经和精神症状。利妥昔单抗对TTP复发有保护作用。总之，巴西的TTP死亡率高于最近队列中观察到的死亡率。该国的TTP诊断和治疗是延迟和过时的，对疾病预后产生负面影响。确保快速诊断和提供TPE和利妥昔单抗（一种具有成本效益的治疗策略）对于改善结果和降低发病率至关重要，包括在低收入和中等收入国家。

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引用次数: 0

Characterizing the impact of traumatic brain injury phenotype on coagulation dynamics in severely injured patients 表征创伤性脑损伤表型对重型颅脑损伤患者凝血动力学的影响

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-14 DOI: 10.1016/j.thromres.2026.109583

Andrew R. Gosselin , Sameer Ahmad , Joseph S. Hanna , Julie Goswami , Valerie Tutwiler

Background

In severely injured patients, altered coagulation impairs stable clot formation and increases mortality. Traumatic brain injury (TBI) precipitates alterations in clot formation and breakdown. In this study, we aimed to characterize clotting kinetics, mechanics, fibrin networks, and circulating proteomic markers in TBI patients, and correlate these biomarkers to outcomes.

Methods

Plasma samples were collected from 63 injured patients upon presentation. Clotting kinetics, structure, fibrinolytic markers, thrombin generation, and proteomic profiles were analyzed. Clinical chart review was performed using our institution's trauma registry and medical records.

Results

We analyzed coagulation and clinical factors of 34 No-TBI, 29 TBI patients and 7 healthy donors. Demographics were comparable between patient groups. TBI patients had increased mortality and larger perturbations in coagulation mainly in intrinsic coagulation and fibrinolytic function. Upon admission, TBI patients had higher D-dimer, lower factor VIII, and lower von Willebrand factor than No-TBI patients. TBI patients had reduced coagulation factor XIII alpha chain than healthy donors. Subgroup analyses included isolated TBI, polytrauma with TBI, and varying TBI severities. We identified distinct contributions of intracranial and extracranial injury on coagulopathy, thrombin generation and coagulation factor concentrations. Along with this, Severe TBI was associated with increased prehospital fibrinolysis, without an increase in tissue plasminogen activator concentration or fibrinolysis at blood draw.

Conclusion

TBI patients demonstrated patterns consistent with prehospital fibrinogen consumption and fibrinolysis. Unique differences were observed between the phenotypes of TBI, with severe isolated TBI patients exhibiting lower levels of vWF, Coagulation Factor VIII, Coagulation Factor XIII alpha chain, and PAI-1. These findings highlight the temporal and injury-phenotype contributions to TBI-induced coagulopathy.

在严重受伤的患者中，凝血功能改变会损害稳定的凝块形成并增加死亡率。外伤性脑损伤（TBI）引起血栓形成和破裂的改变。在这项研究中，我们旨在表征TBI患者的凝血动力学、力学、纤维蛋白网络和循环蛋白质组学标志物，并将这些生物标志物与结果联系起来。方法63例外伤患者就诊时采集血浆标本。分析了凝血动力学、结构、纤维蛋白溶解标志物、凝血酶生成和蛋白质组学特征。临床图表审查使用我们机构的创伤登记和医疗记录。结果分析34例非脑外伤患者、29例脑外伤患者和7例健康供者的凝血及临床因素。患者组间的人口统计数据具有可比性。TBI患者死亡率增高，凝血功能紊乱较大，主要表现为内在凝血功能和纤溶功能紊乱。入院时，与非TBI患者相比，TBI患者的d -二聚体较高，因子VIII较低，血管性血液病因子较低。TBI患者凝血因子XIII α链较健康供者降低。亚组分析包括孤立性TBI、多发创伤合并TBI和不同的TBI严重程度。我们确定了颅内和颅外损伤对凝血功能、凝血酶生成和凝血因子浓度的不同贡献。与此同时，严重TBI与院前纤维蛋白溶解增加有关，而组织纤溶酶原激活物浓度或抽血时纤维蛋白溶解未增加。结论脑外伤患者表现出院前纤维蛋白原消耗和纤维蛋白溶解的规律。在TBI的表型之间观察到独特的差异，严重的孤立性TBI患者表现出较低的vWF、凝血因子VIII、凝血因子XIII α链和PAI-1水平。这些发现强调了颞叶和损伤表型对tbi诱导的凝血病的贡献。

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引用次数: 0

Impact of enduring risk factors on efficacy and safety of extended anticoagulation for provoked venous thromboembolism: Post-hoc analysis of the HI-PRO trial 持久危险因素对诱发性静脉血栓栓塞延长抗凝疗效和安全性的影响：HI-PRO试验的事后分析

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-12 DOI: 10.1016/j.thromres.2026.109588

Mariana Pfeferman , Sina Rashedi , Arvind K. Pandey , Darsiya Krishnathasan , Candrika D. Khairani , Antoine Bejjani , Ruth H. Morrison , Heather Hogan , Junyang Lou , John Fanikos , Nicole Porio , Lisa Rosenbaum , Piotr Sobieszczyk , Zhou Lan , Marie Gerhard-Herman , Umberto Campia , Samuel Z. Goldhaber , Behnood Bikdeli , Gregory Piazza , HI-PRO Trial Investigators

引用次数: 0

Coagulation parameters in gastrointestinal cancer patients with venous thromboembolism 胃肠道肿瘤合并静脉血栓栓塞患者的凝血参数

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-01-12 DOI: 10.1016/j.thromres.2026.109587

Dongyue Fan , Vincent Lanting , Eleonora Camilleri , Mettine H.A. Bos , Araci M.R. Rondon , Henri H. Versteeg

Background

Patients with gastrointestinal (GI) cancer are at increased risk of venous thromboembolism (VTE), which is an important cause of mortality. Risk stratification of VTE in GI cancer remains challenging.

Objectives

To investigate whether assessment of the coagulation system can predict VTE risk in three GI tumor types.

Methods

We used a nested case-control design within the MICA cohort (total N = 81), including 27 patients who developed VTE during follow-up and 54 matched non-VTE controls. The subgroup distribution was esophageal cancer (n = 42), pancreatic cancer (n = 18), and colorectal cancer (n = 21). Plasma samples were analyzed using a multifaceted approach incorporating tissue factor (TF) measurement, thrombin generation, and endothelial function testing within an artificial vessel model. Conditional logistic regression was used to evaluate associations between coagulation parameters and VTE risk.

Results

TF concentrations did not differ between patients with and without VTE across esophageal, colorectal, and pancreatic cancers. In esophageal cancer, prolonged lag time, as well as higher endogenous thrombin potential and peak values in the artificial vessel model, were significantly associated with an increased risk of VTE (OR = 9.95, 95% CI 1.21–81.54; OR = 5.15, 95% CI 1.07–25.00; OR = 10.75, 95% CI 1.31–90.91). No significant differences in coagulation-related parameters were observed in pancreatic or colorectal cancer patients.

Conclusion

Abnormal coagulation may be associated with VTE risk mainly in esophageal cancer, suggesting that VTE biomarkers may differ by cancer type and require further investigation in larger cohorts.

胃肠道（GI）癌症患者发生静脉血栓栓塞（VTE）的风险增加，这是导致死亡的一个重要原因。静脉血栓栓塞在胃肠道癌症中的风险分层仍然具有挑战性。目的探讨凝血系统的评估是否能预测三种消化道肿瘤类型的静脉血栓栓塞风险。方法在MICA队列中采用嵌套病例-对照设计（总N = 81），包括27例在随访期间发生静脉血栓栓塞的患者和54例匹配的非静脉血栓栓塞对照组。亚组分布为食管癌（n = 42）、胰腺癌（n = 18）、结直肠癌（n = 21）。血浆样本分析使用多方面的方法结合组织因子（TF）测量，凝血酶的产生，和内皮功能测试在人工血管模型。使用条件逻辑回归来评估凝血参数与静脉血栓栓塞风险之间的关系。结果食管癌、结直肠癌和胰腺癌患者与非VTE患者之间的stf浓度无差异。在食管癌中，人工血管模型中延迟时间延长、内源性凝血酶电位和峰值升高与VTE风险增加显著相关（OR = 9.95, 95% CI 1.21-81.54; OR = 5.15, 95% CI 1.07-25.00; OR = 10.75, 95% CI 1.31-90.91）。胰腺癌和结直肠癌患者的凝血相关参数无显著差异。结论凝血异常可能主要与食管癌的静脉血栓栓塞风险相关，提示静脉血栓栓塞生物标志物可能因癌症类型而异，需要在更大的队列中进一步研究。

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引用次数: 0