目的探讨人纤维蛋白原(FIB)在急诊创伤性凝血病中的应用及危险因素分析。方法选取2018年1月至2019年12月联保部队第九O八医院收治的100例严重外伤所致创伤性凝血病患者作为观察组,按照随机数字表法分为A组与B组,每组50例;另选取50例急...目的探讨人纤维蛋白原(FIB)在急诊创伤性凝血病中的应用及危险因素分析。方法选取2018年1月至2019年12月联保部队第九O八医院收治的100例严重外伤所致创伤性凝血病患者作为观察组,按照随机数字表法分为A组与B组,每组50例;另选取50例急诊创伤性非凝血病患者作为对照组。A组给予急诊创伤性常规治疗,B组在A组基础上给予人FIB治疗,对照组治疗方法同A组。比较A组和B组治疗前后凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、FIB、D-二聚体(D-D)],24 h新鲜冰冻血浆(FFP)输注量、24 h浓缩红细胞(CRBC)输注量、ICU住院时间及病死率。采用多因素Logistic回归分析影响创伤性凝血病的危险因素。结果治疗后,两组APTT、PT均短于治疗前,FIB水平均高于治疗前,D-D水平均低于治疗前,且B组APTT、PT均短于A组,FIB水平高于A组,D-D水平低于A组,差异有统计学意义(P<0.001)。B组24 h FFP输注量、24 h CRBC输注量均少于A组,病死率低于A组,ICU住院时间短于A组,差异有统计学意义(P<0.05)。观察组APTT、PT均长于对照组,国际标准化比值(INR)、损伤严重程度评分(ISS)、急性生理学和慢性健康状况评价(APACHE)Ⅱ评分、格拉斯哥昏迷(GCS)评分及碱缺失(BD)≥6 mol/L、合并重型颅脑损伤(STBI)、体温<35℃比例均高于对照组,24 h FFP、24 h CRBC输注量均多于对照组,血红蛋白(Hb)水平、血小板计数(PLT)均低于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,PLT低、GCS评分<6分、BD≥6 mol/L、合并STBI是创伤性凝血病发生的独立危险因素(P<0.05)。结论人FIB可改善急性创伤性凝血病凝血功能,减少血液输注量,缩短ICU住院时间及降低病死率,临床疗效显著,PLT低水平、GCS评分<6分、BD≥6 mol/L、合并STBI是创伤性凝血病发生的独立危险因素。展开更多
The fusion protein of Humanized mouse anti-human fibrin ScFv and the low molecuar weight urokinase (IIn-UK) contained seven disulfide bonds and formed inclusion body while expressing in normal E.coli strain.By coexpre...The fusion protein of Humanized mouse anti-human fibrin ScFv and the low molecuar weight urokinase (IIn-UK) contained seven disulfide bonds and formed inclusion body while expressing in normal E.coli strain.By coexpressing DsbC and using the special E.coli strain Origami(DE3) which was trxB/gor double mutant,the fusion protein IIn-UK was functionally expressed in the cytoplasm of E.coli. The expressed fusion protein in the soluble fraction was purified by using affinity chromatography specific against urokinase. The purified fusion protein could combine the thrombus in vitro ,and the specific activity of urokinase reached 80 000IU/mg fusion protein.The result showed that the fusion protein retained the activity of two moieties,and this study laid a foundation for further research of targeting thrombolytic agent.展开更多
文摘目的探讨人纤维蛋白原(FIB)在急诊创伤性凝血病中的应用及危险因素分析。方法选取2018年1月至2019年12月联保部队第九O八医院收治的100例严重外伤所致创伤性凝血病患者作为观察组,按照随机数字表法分为A组与B组,每组50例;另选取50例急诊创伤性非凝血病患者作为对照组。A组给予急诊创伤性常规治疗,B组在A组基础上给予人FIB治疗,对照组治疗方法同A组。比较A组和B组治疗前后凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、FIB、D-二聚体(D-D)],24 h新鲜冰冻血浆(FFP)输注量、24 h浓缩红细胞(CRBC)输注量、ICU住院时间及病死率。采用多因素Logistic回归分析影响创伤性凝血病的危险因素。结果治疗后,两组APTT、PT均短于治疗前,FIB水平均高于治疗前,D-D水平均低于治疗前,且B组APTT、PT均短于A组,FIB水平高于A组,D-D水平低于A组,差异有统计学意义(P<0.001)。B组24 h FFP输注量、24 h CRBC输注量均少于A组,病死率低于A组,ICU住院时间短于A组,差异有统计学意义(P<0.05)。观察组APTT、PT均长于对照组,国际标准化比值(INR)、损伤严重程度评分(ISS)、急性生理学和慢性健康状况评价(APACHE)Ⅱ评分、格拉斯哥昏迷(GCS)评分及碱缺失(BD)≥6 mol/L、合并重型颅脑损伤(STBI)、体温<35℃比例均高于对照组,24 h FFP、24 h CRBC输注量均多于对照组,血红蛋白(Hb)水平、血小板计数(PLT)均低于对照组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,PLT低、GCS评分<6分、BD≥6 mol/L、合并STBI是创伤性凝血病发生的独立危险因素(P<0.05)。结论人FIB可改善急性创伤性凝血病凝血功能,减少血液输注量,缩短ICU住院时间及降低病死率,临床疗效显著,PLT低水平、GCS评分<6分、BD≥6 mol/L、合并STBI是创伤性凝血病发生的独立危险因素。
文摘The fusion protein of Humanized mouse anti-human fibrin ScFv and the low molecuar weight urokinase (IIn-UK) contained seven disulfide bonds and formed inclusion body while expressing in normal E.coli strain.By coexpressing DsbC and using the special E.coli strain Origami(DE3) which was trxB/gor double mutant,the fusion protein IIn-UK was functionally expressed in the cytoplasm of E.coli. The expressed fusion protein in the soluble fraction was purified by using affinity chromatography specific against urokinase. The purified fusion protein could combine the thrombus in vitro ,and the specific activity of urokinase reached 80 000IU/mg fusion protein.The result showed that the fusion protein retained the activity of two moieties,and this study laid a foundation for further research of targeting thrombolytic agent.
