采用不同补氧方式治疗 COVID-19 患者的蛋白 C、蛋白 S 和抗凝血酶 3 活性

Šavuk Ana, Grizelj Danijela, Svaguša Tomo, Čulo Melanie-Ivana, Zagorec Nikola, Šakota Sara, Orehovec Biserka, Kelava Tomislav, Livun Ana, Marković Ivan, Baković Josip, Kereš Tatjana
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摘要

更严重的 COVID-19 以高炎症状态、高凝状态和出现肺微栓塞为特征。在这项研究中,我们希望将 D-二聚体、蛋白 C、蛋白 S 和抗凝血酶 3 的水平与疾病的严重程度和临床结果联系起来。 我们将 134 名患者分为三组,分别给予氧支持(高流量氧疗、机械通气和鼻插管或面罩补氧)。 D-Dimer 的浓度、蛋白 C 和抗凝血酶 3 的活性以平均值(±SD)表示,机械通气患者(3.26 ± 1.15 mg/L、86 ± 22.55 %、81.21±17.61%)/HFNO(2.35±1.68 mg/L,109.6±26.96%,94.67±17.49%)/BNC(1.37±1.17 mg/L,116.92±28.16%,103.29±15.63%)之间存在明显差异,所有参数的P<0.001。氧疗组的死亡率为 10.9%,HFNC 组的死亡率为 40.7%,机械通气组的死亡率为 80%。COVID-19 患者抗凝因子的测定可表明哪些患者发生严重疾病、静脉血栓栓塞和致命临床结局的风险增加。
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Activity of protein C, protein S and antithrombin 3 in COVID-19 patients treated with different modalities of oxygen supplementation
COVID-19 in it is more severe form is characterized by a hyperinflammatory condition, hypercoagulation state and the appearance of pulmonary microembolism. In this study we wanted to correlate levels of D-Dimer, protein C, protein S and antithrombin 3 with severity of disease and clinical outcome. We included 134 of patients who were divided in 3 groups regarding oxygen support (high flow oxygen therapy, mechanical ventilation and oxygen supplementation with nasal cannula or mask). Concentration of D-Dimer, and activity of protein C and antithrombin 3 are presented as mean±SD and differed significantly between patients on mechanical ventilation (3.26 ± 1.15 mg/L, 86 ± 22.55 %, 81.21 ± 17.61 %)/HFNO (2.35 ± 1.68 mg/L, 109.6 ± 26.96 %, 94.67 ± 17.49 %)/BNC (1.37 ± 1.17 mg/L, 116.92 ± 28.16 %, 103.29 ± 15.63 %) with p<0.001 for all parameters. Mortality in oxygen group was 10.9 %, in HFNC group 40.7 % and in mechanical ventilated group 80 %. determination of anticoagulant factors in COVID-19 patients may indicate which of them are at increased risk of developing severe disease, venous thromboembolism and fatal clinical outcome.
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