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Red cell distribution width/platelet ratio estimates the 3-year risk of decompensation in Metabolic Dysfunction-Associated Steatotic Liver Disease-induced cirrhosis
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作者 Marcello Dallio Mario Romeo +8 位作者 Paolo Vaia Salvatore Auletta Simone Mammone Marina Cipullo Luigi Sapio Angela Ragone Marco Niosi Silvio Naviglio Alessandro Federico 《World Journal of Gastroenterology》 SCIE CAS 2024年第7期685-704,共20页
BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to deco... BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients. 展开更多
关键词 Liver cirrhosis red blood cell distribution width red blood cell distribution width to platelet ratio Translational Medicine Prognostic biomarker
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Application of neutrophil-lymphocyte ratio and red blood cell distribution width in diabetes mellitus complicated with heart failure
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作者 Jie Pang Lin-Yan Qian +1 位作者 Ping Lv Xiao-Ru Che 《World Journal of Diabetes》 SCIE 2024年第6期1226-1233,共8页
BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.AIM To explore the value of... BACKGROUND Accumulating clinical evidence has shown that diabetes mellitus(DM)is a serious risk factor for cardiovascular disorders and an important factor for adverse cardiovascular events.AIM To explore the value of the combined determination of the neutrophil-lymphocyte ratio(NLR)and red blood cell distribution width(RDW)in the early diagnosis and prognosis evaluation of DM complicated with heart failure(HF).METHODS We retrospectively analyzed clinical data on 65 patients with type 2 DM(T2DM)complicated with HF(research group,Res)and 60 concurrent patients with uncomplicated T2DM(control group,Con)diagnosed at Zhejiang Provincial People’s Hospital between January 2019 and December 2021.The NLR and RDW values were determined and comparatively analyzed,and their levels in T2DM+HF patients with different cardiac function grades were recorded.The receiver operating characteristic(ROC)curves were plotted to determine the NLR and RDW values(alone and in combination)for the early diagnosis of HF.The correlation between NLR and RDW with the presence or absence of cardiac events was also investigated.RESULTS Higher NLR and RDW levels were identified in the Res vs the Con groups(P<0.05).The NLR and RDW increased gradually and synchronously with the deterioration of cardiac function in the Res group,with marked differences in their levels among patients with grade II,III,and IV HF(P<0.05).ROC curve analysis revealed that NLR combined with RDW detection had an area under the curve of 0.915,a sensitivity of 76.9%,and a specificity of 100%for the early diagnosis of HF.Furthermore,HF patients with cardiac events showed higher NLR and RDW values compared with HF patients without cardiac events.CONCLUSION NLR and RDW were useful laboratory indicators for the early diagnosis of DM complicated with HF,and their joint detection was beneficial for improving diagnostic efficiency.Additionally,NLR and RDW values were directly proportional to patient outcomes. 展开更多
关键词 Neutrophil-lymphocyte ratio red blood cell distribution width Type 2 diabetes Heart failure Early diagnosis
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Plasma and Red Blood Cells Concentration Profiles of Ktamine after Single Intravenous Administration in an Anaesthetic Protocol in Horses
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作者 Francesca Sori Noemi Romagnoli +2 位作者 Domenico Ferrara Anna Zaghini Paola Roncada 《Open Journal of Veterinary Medicine》 2013年第2期136-142,共7页
The aim of this study was to describe the concentration profile of ketamine in plasma and red blood cells following an intravenous (IV) bolus in the horse. Ten healthy standardbred horses (two males and height females... The aim of this study was to describe the concentration profile of ketamine in plasma and red blood cells following an intravenous (IV) bolus in the horse. Ten healthy standardbred horses (two males and height females) 7.7 ± 4.6 (mean value ± SD) years old and weighting 380 ± 21 kg (mean value ± SD) were recruited. The horses were premedicated with acepromazine (0.04 mg·kg-1·IV). Fifteen minutes later they received romifidine (0.08 mg·kg-1·IV), and 5 minutes after they were administered midazolam (0.06 mg·kg-1·IV). Immediately, anaesthesia was induced by ketamine (2.2 mg·kg-1·IV). Venous blood samples were collected at scheduled time points. Plasma and red blood cells (RBCs) concentration of ketamine was assayed using a high performance liquid chromatographic method (HPLC/UV-DAD). The high mean recovery rates, the high sensitivity, the good linearity, suggest a clinical applicability of the analytical method. A bicompartmental model resulted as the most appropriate to describe the ketamine concentration—time profile for both plasma and RBCs. The fitted regression line between ketamine plasma concentrations and RBC concentrations supports the good correlation between ketamine concentrations in plasma and in RBCs. The kinetic parameters of ketamine calculated for RBC are equal or very similar to the plasma ones. The study confirms the kinetic behaviour of ketamine used in the horse as anaesthetic inducers in routine surgery. Finally, the bicompartmental model well describes the ketamine profile also in RBCs, that it is very close to the plasma profile, underlining the great importance of RBCs as blood subcompartment. 展开更多
关键词 KETAMINE HORSE plasma red blood cells Kinetics
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Red cell distribution width-to-albumin ratio is a simple promising prognostic marker in acute cholangitis requiring biliary drainage
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作者 Fatih Acehan Hüseyin Camli +4 位作者 Cagdas Kalkan Mesut Tez Burak Furkan Demir Emin Altiparmak Ihsan Ates 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第5期487-494,共8页
Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investi... Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investigate the predictive value of the red cell distribution width(RDW)-to-albumin ratio(RAR) for the prognosis of AC. Methods: We retrospectively evaluated consecutive patients diagnosed with AC between May 2019 and March 2022. RAR was calculated, and its predictive ability for in-hospital mortality, intensive care unit(ICU) admission, bacteremia, and the length of hospitalization were analyzed. Results: Out of 438 patients, 34(7.8%) died. Multivariate analysis showed that malignant etiology [odds ratio(OR) = 4.816, 95% confidence interval(CI): 1.936-11.980], creatinine(OR = 1.649, 95% CI: 1.095-2.484), and RAR(OR = 2.064, 95% CI: 1.494-2.851) were independent risk factors for mortality. When adjusted for relevant covariates, including age, sex, malignant etiology, Tokyo severity grading(TSG), Charlson comorbidity index, and creatinine, RAR significantly predicted mortality(adjusted OR = 1.833, 95% CI: 1.280-2.624). When the cut-off of RAR was set to 3.8, its sensitivity and specificity for mortality were 94.1% and 56.7%, respectively. Patients with an RAR of > 3.8 had a 20.9-fold(OR = 20.9, 95% CI: 4.9-88.6) greater risk of mortality than the remaining patients. The area under the curve value of RAR for mortality was 0.835(95% CI: 0.770-0.901), which was significantly higher than that of TSG and the other prognostic markers, such as C-reactive protein-to-albumin ratio, and procalcitonin-to-albumin ratio. Lastly, RAR was not inferior to TSG in predicting ICU admission, bacteremia, and the length of hospitalization. Conclusions: RAR successfully predicted the in-hospital mortality, ICU admission, bacteremia, and the length of hospitalization of patients with AC, especially in-hospital mortality. RAR is a promising marker that is more convenient than TSG and other prognostic markers for predicting the prognosis of patients with AC. 展开更多
关键词 Acute cholangitis ALBUMIN Biliary drainage MORTALITY red blood cell distribution width-to-albumin ratio
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Study on the packed volume and the void ratio of idealized human red blood cells using a ?nite-discrete element method 被引量:1
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作者 Dong XU Chunning JI +3 位作者 A.MUNJIZA E.KALIVIOTIS E.AVITAL J.WILLAMS 《Applied Mathematics and Mechanics(English Edition)》 SCIE EI CSCD 2019年第5期737-750,共14页
Numerical simulations are performed to examine the packing behavior of human red blood cells(RBCs). A combined ?nite-discrete element method(FDEM) is utilized, in which the RBCs are modeled as no-friction and no-adhes... Numerical simulations are performed to examine the packing behavior of human red blood cells(RBCs). A combined ?nite-discrete element method(FDEM) is utilized, in which the RBCs are modeled as no-friction and no-adhesion solid bodies. The packed volume and the void ratio of a large number of randomly packed RBCs are clari?ed,and the effects of the RBC shape, the mesh size, the cell number, and the container size are investigated. The results show that the packed human RBCs with normal shape have a void ratio of 28.45%, which is slightly higher than that of the ?at or thick cells used in this study. Such information is bene?cial to the further understanding on the geometric features of human RBCs and the research on RBC simulations. 展开更多
关键词 red blood cell (RBC) VOID ratio packed VOLUME DISCRETE element method
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Successful treatment of severe hepatic impairment in erythropoietic protoporphyria:A case report and review of literature
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作者 Tao Zeng Shu-Ru Chen +2 位作者 Hao-Qiang Liu Yu-Tian Chong Xin-Hua Li 《World Journal of Hepatology》 2024年第6期966-972,共7页
BACKGROUND Erythropoietic protoporphyria(EPP)is a rare genetic disorder stemming from ferrochelatase gene mutations,which leads to abnormal accumulation of protoporphyrin IX primarily in erythrocytes,skin,bone marrow ... BACKGROUND Erythropoietic protoporphyria(EPP)is a rare genetic disorder stemming from ferrochelatase gene mutations,which leads to abnormal accumulation of protoporphyrin IX primarily in erythrocytes,skin,bone marrow and liver.Although porphyria-related severe liver damage is rare,its consequences can be severe with limited treatment options.CASE SUMMARY This case study highlights a successful intervention for a 35-year-old male with EPP-related liver impairment,employing a combination of red blood cell(RBC)exchange and therapeutic plasma exchange(TPE).The patient experienced significant symptom relief and a decrease in bilirubin levels following multiple PE sessions and an RBC exchange.CONCLUSION The findings suggest that this combined approach holds promise for managing severe hepatic impairment in EPP. 展开更多
关键词 Erythropoietic protoporphyria red blood cell exchange plasma exchange Delta-aminolevulinic acid FERROCHELATASE Case report
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Red blood cells (ABCs) in plasma can survive freeze thaw
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《中国输血杂志》 CAS CSCD 2001年第S1期422-,共1页
关键词 in plasma can survive freeze thaw ABCs red blood cells
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Red blood cell distribution width derivatives in alcohol-related liver cirrhosis and metabolic-associated fatty liver disease 被引量:5
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作者 Agata Michalak Małgorzata Guz +4 位作者 Joanna Kozicka Marek Cybulski Witold Jeleniewicz Tomasz Lach Halina Cichoż-Lach 《World Journal of Gastroenterology》 SCIE CAS 2022年第38期5636-5647,共12页
BACKGROUND Looking for undiscovered blood markers of liver fibrosis and steatosis still remains an issue worth exploring.There are still plenty of unresolved issues related to the actual role of hematological indices ... BACKGROUND Looking for undiscovered blood markers of liver fibrosis and steatosis still remains an issue worth exploring.There are still plenty of unresolved issues related to the actual role of hematological indices as potential markers of liver function.AIM To study red blood cell distribution width(RDW),RDW-to-platelet ratio(RPR)and RDW-to-lymphocyte ratio(RLR) in alcohol-related liver cirrhosis(ALC) and metabolic-associated fatty liver disease(MAFLD).METHODS The study group was composed of 302 people:142 patients with ALC and 92 with MAFLD;68 persons were included as controls.RDW,RPR and RLR were measured in each person.Indirect and direct parameters of liver fibrosis were also assessed [aspartate transaminase to alkaline transaminase ratio,aspartate transaminase to platelet ratio index(APRI),fibrosis-4(FIB-4),gamma-glutamyl transpeptidase to platelet ratio(GPR),procollagen I carboxyterminal propeptide,procollagen Ⅲ aminoterminal propeptide,transforming growth factor-α,plateletderived growth factor AB,laminin].MELD score in ALC patients and nonalcoholic fatty liver disease(NAFLD) fibrosis score together with BARD score were obtained in the MAFLD group.The achieved results were compared to controls.Then a correlation between assessed markers was done.Diagnostic value of each investigated parameter and its suggested cut-off in the research group RESULTS RDW,RPR and RLR values turned out to be significantly higher in ALC and MAFLD groups compared to controls(ALC:P<0.0001;NAFLD:P<0.05,P<0.0001 and P<0.0001,respectively).RPR correlated positively with MELD score(P<0.01) and indirect indices of liver fibrosis(FIB-4 and GPR;P<0.0001) in ALC patients;negative correlations were found between PDGF-AB and both:RDW and RPR(P<0.01 and P<0.0001,respectively).RPR correlated positively with NAFLD fibrosis score and APRI(P<0.0001) in the MAFLD group;a positive relationship was observed between RDW and FIB-4,too(P<0.05).AUC values and suggested cut-offs for RDW,RPR and RLR in ALC patients were:0.912(>14.2%),0.965(>0.075) and 0.914(>8.684),respectively.AUC values and suggested cut-offs for RDW,RPR and RLR in MAFLD patients were:0.606(>12.8%),0.724(>0.047) and 0.691(>6.25),respectively.CONCLUSION RDW with its derivatives appear to be valuable diagnostic markers in patients with ALC.They can also be associated with a deterioration of liver function in this group. 展开更多
关键词 Hematological indices Alcohol-related liver cirrhosis Metabolic-associated liver disease red blood cell distribution width red blood cell distribution width-to-platelet ratio red blood cell distribution width-to-lymphocyte ratio
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Direct passive hemagglutination test for rapid quantification of plasma load of the <i>Human Immunodeficiency Virus</i>
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作者 Maduike C. O. Ezeibe Augustine A. Ngene +4 位作者 Ifeanyichukwu Anene Bridget Amechi Peter Olowoniyi James I. Eze Paul C. Animoke 《Health》 2013年第9期1351-1354,共4页
An inexpensive and rapid test for determining titers of Human Immunodeficiency Virus (HIV) in plasmas was developed. Washed sheep red blood cells were applied onto HIV positive plasmas, in V-bottomed microtiter plates... An inexpensive and rapid test for determining titers of Human Immunodeficiency Virus (HIV) in plasmas was developed. Washed sheep red blood cells were applied onto HIV positive plasmas, in V-bottomed microtiter plates, to complement the HIV antigens and antibodies present in plasmas. The setup was incubated for 30 minutes at 37℃. Reciprocal of the highest dilution of each plasma which gave passive agglutination of the RBCs was read as its HIV titer. Mean HIV load of five samples, was ≥ 4096.00 ± 0.00 after one day of storage at 4℃ but it reduced to 256.00 ± 70.10, 28.80 ± 3.20, 7.20 ± 0.80 and 1.60 ± 0.98 on days 2, 3, 4 and 7, respectively. HIV antibodies were still detectable, by ELISA, in plasma dilutions that were tested negative with the new test. It was concluded that when HIV antibodies have been confirmed, or added to plasmas, passive hemagglutination test can be applied to assess their viral loads. 展开更多
关键词 HIV ANTIBODIES ANTIGENS plasma SHEEP red blood cells
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血液成分二次制备后相关参数变化
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作者 郭敏 陈君 +3 位作者 杨宁 和苗 李建民 杨文娟 《中国输血杂志》 CAS 2024年第5期586-590,612,共6页
目的 对成分血二次制备后的相关参数变化进行研究,旨在进一步提升血液成分产品质量。方法 选择不同的离心条件用于初次成分血去白细胞悬浮红细胞的制备,并对其进行质量检测,然后以去白细胞悬浮红细胞为二次制备的起始血液,通过ACP215红... 目的 对成分血二次制备后的相关参数变化进行研究,旨在进一步提升血液成分产品质量。方法 选择不同的离心条件用于初次成分血去白细胞悬浮红细胞的制备,并对其进行质量检测,然后以去白细胞悬浮红细胞为二次制备的起始血液,通过ACP215红细胞处理系统去制备机制洗涤红细胞成分血,并对其进行质量检测,通过对成分血制备参数的变化进行观察研究比较,并从中进行优化调整。结果 不同的离心条件所带来的离心效果相当时,所分离制备的去白细胞悬浮红细胞和冰冻血浆初级血液成分,其容量、血红蛋白、血细胞比积、白细胞残留量等质量控制项目,均符合国家相关标准要求;同时以初次制备的去白细胞悬浮红细胞为起始血液制备的机制,洗涤红细胞二级血液成分,其容量、血红蛋白、上清蛋白含量等质量控制项目,除容量超出标准7~14 mL外,其余均符合国家相关标准要求,但导致容量超标的原因及采取的解决方法可控制容量达到标准范围,且在红细胞回收率和血浆蛋白清除率上,二者可分别达到75%和99%的水平。结论 本实验初次制备与二次制备的血液成分之间有着一定的关联,但血液成分二次制备可视实际情况进行相关参数的灵活调整,以确保制备的成分血产品质量符合国家相关标准要求,以及临床治疗效果和安全。 展开更多
关键词 成分血 初次处理血液成分 二次处理血液成分 去白细胞悬浮红细胞 血浆 洗涤红细胞
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急性脑梗死静脉溶栓患者的CRP、NLR和LER动态变化及其对预后的预测价值
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作者 薛冰 郭中霞 《河南医学研究》 CAS 2024年第7期1261-1265,共5页
目的探讨急性脑梗死(ACI)静脉溶栓患者的C反应蛋白(CRP)、中性粒细胞和淋巴细胞比值(NLR)及白细胞和红细胞计数比值(LER)的动态变化及其对患者预后的预测价值。方法选择商丘市第一人民医院2020年2月至2023年2月急诊就诊的ACI且在院进行... 目的探讨急性脑梗死(ACI)静脉溶栓患者的C反应蛋白(CRP)、中性粒细胞和淋巴细胞比值(NLR)及白细胞和红细胞计数比值(LER)的动态变化及其对患者预后的预测价值。方法选择商丘市第一人民医院2020年2月至2023年2月急诊就诊的ACI且在院进行静脉溶栓治疗的126例患者。根据发病后90 d改良Rankin量表评分(mRS)将所有患者分为预后良好组(94例)及预后不良组(32例)。比较两组溶栓前、溶栓后1 d、溶栓后7 d的CRP、NLR、LER的变化情况及发病90 d的mRS评分。采用Cox回归分析影响ACI静脉溶栓患者预后的相关因素。采用Spearman相关性分析CRP、NLR、LER水平与ACI静脉溶栓患者mRS评分的相关性。采用受试者工作特征(ROC)曲线分析溶栓后1 d及7 d的CRP、NLR、LER的变化情况对ACI静脉溶栓患者预后的预测价值。结果重复测量方差分析显示,两组CRP、NLR、LER在时间效应、组间效应及交互效应均有统计学意义(P<0.05);简单效应分析,预后良好组患者溶栓后1 d及7 d的CRP、NLR、LER水平低于预后不良组(P<0.05)。预后良好组发病90 d的mRS评分分布优于预后不良组(P<0.05)。Cox回归分析结果显示溶栓后1 d及7 d的CRP、NLR、LER水平均是ACI静脉溶栓患者预后的相关影响因素。Spearman相关性分析示,溶栓后1 d及7 d的CRP、NLR、LER水平与ACI静脉溶栓患者发病90 d的mRS评分呈正相关(r=0.405、0.481、0.518、0.680、0.530、0.504,P<0.05)。ROC曲线结果显示溶栓后7 d的CRP、NLR、LER及三者联合的曲线下面积(AUC)均大于溶栓后1 d的各项对应指标及联合指标的AUC,溶栓后7 d各项指标联合预测ACI静脉溶栓患者预后的AUC最大,为0.856。结论ACI静脉溶栓患者的CRP、NLR、LER随患者病情改善呈逐渐下降趋势,且与患者的预后相关,3种指标联合检测对ACI静脉溶栓患者预后的预测价值更高。 展开更多
关键词 急性脑梗死 静脉溶栓 白细胞和红细胞计数比值 预后
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新冠肺炎疫情对国内25家地级市中心血站全血制备成分血的供应影响分析
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作者 葛晓芹 付恒 +21 位作者 胡官林 曹彩霞 杨维涛 王振兴 周国琼 付竹筠 孙婧雯 沈有华 燕锋 鲍琳 林富文 李丽 王泽颖 冯兰洁 周竞 康美艳 张剑 刘保霞 汤文隽 郭萍莉 李浩 邱艳 《临床输血与检验》 CAS 2024年第2期244-250,共7页
目的分析2017—2022年国内25家地市级中心血站全血制备的成分血供应情况是否受到新冠肺炎疫情的影响。方法采用回顾性研究方法,收集2017—2022年国内25家中心血站红细胞成分血、冰冻血浆、冷沉淀凝血因子、病原体灭活冰冻血浆、调剂红... 目的分析2017—2022年国内25家地市级中心血站全血制备的成分血供应情况是否受到新冠肺炎疫情的影响。方法采用回顾性研究方法,收集2017—2022年国内25家中心血站红细胞成分血、冰冻血浆、冷沉淀凝血因子、病原体灭活冰冻血浆、调剂红细胞成分血和冰冻血浆的发放数据,根据新冠疫情发生时间(2019年底),将发放数据分为两组,2017年、2018年、2019年为非新冠疫情组(简称非疫情组),2020年、2021年、2022年为新冠疫情组(简称疫情组)。结果2017—2022年,红细胞成分血发放量呈波动增长,2022年>2021年>2019年>2020年>2018年>2017年,2020年较2019年下降19724.12 U,呈负增长(–1.43%),与中心血站显著相关(P<0.05);冰冻血浆发放量呈逐年递增,2022年>2021年>2020年>2019年>2018年>2017年,与中心血站显著相关(P<0.05);冷沉淀凝血因子发放量基本呈逐年递增,2021年>2022年>2020年>2019年>2018年>2017年,2022年较2021年下降6303.72 U,呈负增长(–1.54%),与中心血站显著相关(P<0.05)。2020—2022年,病原体灭活冰冻血浆发放量呈波动增长;年度同比增长率2021年呈负增长,2022年呈正增长;调剂红细胞成分血发放量呈逐年递减,年度同比增长率呈负增长;调剂冰冻血浆发放量呈逐年递减,年度同比增长率呈负增长。结论国内25家中心血站全血制备成分血的供应情况地区差异大,受新冠疫情的影响程度亦不同,总体上对2020年的供应能力影响最显著,血液调剂是新冠疫情期间保证血液供应的措施之一。 展开更多
关键词 新冠疫情 血液供应 红细胞成分血 冰冻血浆 冷沉淀凝血因子 病原体灭活冰冻血浆
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术中血浆输注剂量对心脏外科手术患者临床预后的影响
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作者 李丹丹 黄国栋 +1 位作者 马伟 刘怡伶 《中山大学学报(医学科学版)》 CAS CSCD 北大核心 2024年第3期466-474,共9页
【目的】评估术中血浆输注剂量,凝血实验测试值INR对心脏外科手术患者临床预后的影响,为指导心脏外科手术术中合理用血提供依据。【方法】收集中山大学孙逸仙纪念医院2014年1月至2022年12月期间术中输注新鲜冰冻血浆的305例心脏外科手... 【目的】评估术中血浆输注剂量,凝血实验测试值INR对心脏外科手术患者临床预后的影响,为指导心脏外科手术术中合理用血提供依据。【方法】收集中山大学孙逸仙纪念医院2014年1月至2022年12月期间术中输注新鲜冰冻血浆的305例心脏外科手术患者的临床资料,并根据术中血浆输注剂量分为低剂量组(血浆输注剂量<15 mL/kg,n=214)和高剂量组(血浆输注剂量≥15 mL/kg,n=91),并通过单因素,相关性以及Logistic多因素回归分析,探讨血浆输注量,血浆输注前后INR的变化情况与心脏外科手术患者临床预后之间的关系。【结果】最终共有305例心脏外科手术患者纳入研究分析,所有患者术中血浆输注剂量的中位数(四分位间距)为11.11(8.17~19.05)mL/kg,其中高剂量组与低剂量组患者术中血浆输注剂量的中位数(四分位间距)分别为17.78(15.69~20.91)mL/kg和9.52(7.77~11.43)mL/kg,两者差异具有统计学意义(P<0.001)。高低剂量组血浆输注前后INR变化值中位数(四分位间距)分别为0.98(0.60~1.26)和0.50(0.35~0.76),两者差异具有统计学意义(P<0.001)。Logistic多因素回归分析显示,术前INR值的异常升高导致心脏外科手术患者术后24 h内输注红细胞的风险增加(P<0.001),OR 95%CI为6.757(3.068,14.822),同时也增加手术患者术后住院死亡风险(P<0.001),OR 95%CI为5.441(2.193,13.499);术中血浆输注前后INR的改变值降低了心脏外科手术患者术后24 h内输注红细胞的风险(P=0.001),OR 95%CI为0.244(0.107,0.558)。相关性分析显示,术中血浆剂量与心脏外科手术患者术后ICU时间(rs=0.569,P<0.001)和住院时间(rs=0.302,P<0.001)呈正相关。【结论】在接受术中血浆输注的心脏外科手术患者中,高血浆输注剂量和术前异常高的INR值与较差的临床预后有关,而输注血浆后INR值校正程度更高的手术患者显示出较好的临床结果。 展开更多
关键词 血浆剂量 心脏外科 国际标准化比率 红细胞 临床预后
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中性粒细胞与淋巴细胞比值联合红细胞分布宽度在急诊老年脓毒症病人中的应用价值
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作者 杨海龙 王冬利 +2 位作者 刘燕平 王晶 王长远 《安徽医药》 CAS 2024年第4期676-680,共5页
目的 探讨中性粒细胞与淋巴细胞比值(NLR)结合红细胞分布宽度(RDW)对急诊老年脓毒症病人疾病严重程度和预后的评估意义。方法 收集2019年1月到2022年2月在首都医科大学宣武医院急诊科就诊及住院治疗的老年脓毒症病人169例。病人入急诊... 目的 探讨中性粒细胞与淋巴细胞比值(NLR)结合红细胞分布宽度(RDW)对急诊老年脓毒症病人疾病严重程度和预后的评估意义。方法 收集2019年1月到2022年2月在首都医科大学宣武医院急诊科就诊及住院治疗的老年脓毒症病人169例。病人入急诊后给予生化全项、血气分析、全血细胞计数、降钙素原(PCT)、胸部计算机体层摄影(CT)、病原学检查等。依据以上检查结果进行急性生理与慢性健康状况评估(APACHEⅡ)。根据病人入急诊时合并脓毒性休克情况分为脓毒症组114例和脓毒性休克组55例。随访28 d,依据病人死亡情况分成生存组125例和死亡组44例。分别比较脓毒性休克组和脓毒症组、生存组和死亡组病人NLR、白细胞计数(WBC)、PCT、RDW和APACHEⅡ评分的区别,进行NLR、RDW与PCT及APACHEⅡ评分的相关性分析;分析RDW、NLR及2个指标相互结合评估老年脓毒症病人死亡风险的受试者工作特征曲线下面积(AUC)和PCT曲线下面积的区别。结果 脓毒症休克组病人PCT、NLR、RDW和APACHEⅡ评分分别为(1.86±1.04)μg/L、9.63±3.92、(14.95±3.49)%和(16.75±3.53)分,均明显高于脓毒症组的(1.38±1.06)μg/L、7.87±3.94、(12.74±3.83)%、(14.61±2.87)分(P<0.01);WBC在脓毒症死亡组与生存组比较差异无统计学意义(P=0.361),死亡组APACHEⅡ评分、NLR、PCT和RDW分别为(18.52±2.41)分、(10.64±3.74)、(2.55±1.14)μg/L和(15.98±3.69)%,均大于生存组的(14.17±2.71)分、7.67±3.82、(1.19±0.81)μg/L、(12.57±3.43)%(P<0.01),RDW和NLR均与APACHEⅡ评分和PCT具有相关性(均P<0.01);PCT的AUC 95%CI为0.86(0.80,0.92),APACHEⅡ评分的AUC 95%CI为0.88(0.83,0.93),RDW的AUC 95%CI为0.75(0.66,0.83),NLR的AUC95%CI为0.73(0.64,0.81),RDW和NLR的AUC均小于PCT(P=0.048,0.024),但RDW与NLR联合的AUC为0.80,与PCT比较差异无统计学意义(P=0.363)。结论 NLR及RDW两个指标都能够在急诊老年脓毒症病人的病情和预后评估中有较好的应用价值,二者联合的应用价值与PCT相近。 展开更多
关键词 脓毒症 红细胞分布宽度 中性粒细胞与淋巴细胞比值 降钙素原 急性生理与慢性健康状况评估 老年人
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静脉双功超声联合红细胞分布宽度、血小板/淋巴细胞预测烧伤患者静脉血栓栓塞症的价值研究
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作者 马继中 王野平 +1 位作者 孔敏刚 李杨 《浙江医学》 CAS 2024年第5期490-495,共6页
目的 探讨静脉双功超声(DUS)联合红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)对烧伤患者静脉血栓栓塞症(VTE)发生风险的预测价值。方法 回顾性分析2020年4月至2023年4月金华市中心医院收治的烧伤患者126例,治疗后常规随访6个月,以... 目的 探讨静脉双功超声(DUS)联合红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)对烧伤患者静脉血栓栓塞症(VTE)发生风险的预测价值。方法 回顾性分析2020年4月至2023年4月金华市中心医院收治的烧伤患者126例,治疗后常规随访6个月,以静脉血管造影为金标准分为VTE组25例和无VTE组101例。治疗前采用DUS检测下肢深静脉的管腔直径和峰值流速,由经验丰富的超声科医师进行血栓定性诊断;检测患者血生化指标包括RBC、RDW、PLT、PLR以及凝血功能指标。比较两组患者的临床资料、治疗前的超声参数和血生化指标;分析患者下肢深静脉峰值流速与RDW、D-二聚体、Fib、PLR及血栓风险评估表(Caprini评分)的相关性;以静脉血管造影结果为金标准,分析DUS血栓定性诊断的价值;分析下肢深静脉峰值流速、RDW和PLR对VTE的诊断效能。结果 与无VTE组比较,VTE组患者年龄和烧伤面积占体表总面积百分比增加,管腔直径、RDW、D-二聚体和Fib水平均增加(均P<0.05),而峰值流速和PLR降低(均P<0.05)。峰值流速与RDW、D-二聚体和Fib水平均呈负相关(均P<0.05),与PLR呈正相关(P<0.05)。DUS血栓定性诊断的准确度为0.889,灵敏度为0.800,特异度为0.911,阳性预测值为0.690,阴性预测值为0.948。ROC曲线分析显示,峰值流速、RDW和PLR诊断VTE的AUC分别为0.723、0.698和0.623,峰值流速联合RDW诊断VTE的AUC为0.797,高于单一指标(均P<0.05)。结论 DUS或可作为临床筛查和诊断VTE的首选无创工具,峰值流速联合RDW能够提供更多VTE的血流信息,能够更好地预测烧伤患者VTE的发生风险。 展开更多
关键词 静脉双功超声 红细胞分布宽度 血小板与淋巴细胞比值 烧伤 静脉血栓栓塞症
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不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克的效果分析
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作者 赵贤贤 崔健 《系统医学》 2024年第9期45-48,共4页
目的对不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克的效果进行分析。方法回顾性选取2021年6月—2023年6月济宁市第一人民医院接受相关治疗的84例创伤失血性休克患者的临床资料,按照不同输血方案,分为参照组(42例)及研究组(42例... 目的对不同冰冻血浆与红细胞比例输血方案治疗创伤失血性休克的效果进行分析。方法回顾性选取2021年6月—2023年6月济宁市第一人民医院接受相关治疗的84例创伤失血性休克患者的临床资料,按照不同输血方案,分为参照组(42例)及研究组(42例)。参照组使用冰冻血浆∶红细胞比例为1∶2的输血方案对干预治疗,研究组使用冰冻血浆∶红细胞比例为1∶1的输血方案对干预治疗。对比两组输血前及输血后的凝血功能指标以及输血前、输血后的血栓弹力图(Thromboela-stogram,TEG)参数水平。结果研究组输血后的凝血功能指标水平优于参照组,差异有统计学意义(P<0.05);输血后研究组α角(68.55±5.38)°、MA(62.84±5.47)mm、K(2.63±0.61)min、R(4.37±1.33)min等TEG参数水平均优于参照组,差异有统计学意义(t=9.085、9.005、5.407、3.774,P均<0.001)。结论对创伤失血性休克患者实施1:1的冰冻血浆:红细胞输血方案可获得理想治疗效果,不仅可强化患者凝血功能,并且可在一定程度上提升患者血栓弹力图参数水平,对患者身体康复发挥着一定促进作用。 展开更多
关键词 创伤失血性休克 冰冻血浆 红细胞 住院时间 凝血功能
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复荣通脉胶囊对ACS-PCI患者红细胞分布宽度和血小板与淋巴细胞比值的影响
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作者 张美玉 张贺翔 +4 位作者 吴琼 韩露轩 王植荣 齐文秀 刘洋 《辽宁中医药大学学报》 CAS 2024年第5期120-124,共5页
目的评价复荣通脉胶囊对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后红细胞分布宽度(RDW)和血小板与淋巴细胞比值(PLR)的影响。方法选取2019年6月—2021年6月河北省沧州中西医结合医院确诊ACS并进行PCI术的168例患者为... 目的评价复荣通脉胶囊对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后红细胞分布宽度(RDW)和血小板与淋巴细胞比值(PLR)的影响。方法选取2019年6月—2021年6月河北省沧州中西医结合医院确诊ACS并进行PCI术的168例患者为研究对象,均口服复荣通脉胶囊至少3个月,中位时间8.5个月。所有患者PCI术后常规随访12个月,根据是否有短期主要心脏不良事件(major adverse cardiac events,MACE)分为MACE组24例与无MACE组144例,比较两组术后和随访12个月时的RDW和PLR值。分析MACE与RDW、PLR的相关性,并分析RDW、PLR对ACS-PCI术后MACE发生的预测价值。结果MACE组复荣通脉胶囊服用时间明显短于无MACE组(P<0.05),两组术后RDW和PLR比较,差异无统计学意义(P>0.05),但MACE组随访12个月时RDW比无MACE组明显升高(P<0.05),而PLR则明显下降(P<0.05)。Logistic回归分析显示,复荣通脉胶囊服用时间、RDW和PLR均是ACS-PCI患者随访12个月时MACE发生的预测因素(P<0.05)。受试者工作曲线(ROC)显示,RDW和PLR预测ACS-PCI术后MACE发生的曲线下面积(AUC)分别为0.854和0.897(P<0.05)。结论复荣通脉胶囊及其服用时间长短对ACS-PCI术后MACE发生具有重要影响,复荣通脉胶囊服用时间、RDW和PLR均是ACS-PCI术后MACE发生的预测因素,长期服用复荣通脉胶囊可降低RDW值,升高PLR值,进而降低ACS-PCI术后MACE的发生率。 展开更多
关键词 复荣通脉胶囊 急性冠状动脉综合征 经皮冠状动脉介入 主要心脏不良事件 红细胞分布宽度 血小板与淋巴细胞比值
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不同血浆与红细胞输注比例对创伤后大出血患者救治效果及凝血功能的影响
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作者 刘慧如 何颖 周园园 《川北医学院学报》 CAS 2024年第4期544-547,共4页
目的:探讨不同血浆(FFP)与红细胞(RBC)输注比例对创伤后大出血患者救治效果及凝血功能的影响。方法:选取125例创伤后大出血患者为研究对象,按照救治时FFP/RBC输注比例不同分为A组(n=42)、B组(n=44)和C组(n=39)。A组输注比例0.5~1.0;B组... 目的:探讨不同血浆(FFP)与红细胞(RBC)输注比例对创伤后大出血患者救治效果及凝血功能的影响。方法:选取125例创伤后大出血患者为研究对象,按照救治时FFP/RBC输注比例不同分为A组(n=42)、B组(n=44)和C组(n=39)。A组输注比例0.5~1.0;B组输注比例>1.0~1.5;C组输注比例>1.5~2.0。比较各组患者救治效果(入院24 h死亡率、ICU停留时间及住院时间)、血常规[血红蛋白(Hb)、血小板计数(Plt)水平]、凝血功能[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)及国际标准化比值(INR)水平]、纤溶功能[D-二聚体(D-D)、蛋白C(PC)及纤维蛋白降解产物(FDP)水平]及血制品输注量。结果:各组患者入院24 h死亡率、ICU停留时间及住院时间无统计学差异(P>0.05)。输血后,各组患者APTT、PT、Plt、D-D、INR、PC水平比较:A组<B组<C组(P<0.05)。各组患者FFP输注量比较:A组>B组>C组(P<0.05)。结论:救治创伤后大出血患者过程中推荐FFP/RBC的输注比例为>1.0~1.5,在保证救治效果的前提下,能有效促进凝血功能恢复,节约血制品。 展开更多
关键词 血浆与红细胞输注比例 救治效果 回顾性研究 创伤后大出血 凝血功能
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NICU新生儿输注血液制剂的现状分析
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作者 刘海燕 《检验医学与临床》 2024年第5期677-681,686,共6页
目的 分析新生儿重症监护室(NICU)新生儿输注血液制剂的现状,为更好地指导新生儿输血提供参考依据。方法 回顾性收集2012年1月至2022年12月该院NICU收治的406例输注血液制剂新生儿的病历资料,分析新生儿输注红细胞、血浆、冷沉淀及血小... 目的 分析新生儿重症监护室(NICU)新生儿输注血液制剂的现状,为更好地指导新生儿输血提供参考依据。方法 回顾性收集2012年1月至2022年12月该院NICU收治的406例输注血液制剂新生儿的病历资料,分析新生儿输注红细胞、血浆、冷沉淀及血小板的分布特点以及输注前后血常规指标[血红蛋白(Hb)、红细胞比容(HCT)、红细胞分布宽度(RDW)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞平均体积(MCV)]、凝血指标[国际标准化比率(INR)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、生化指标[总胆红素、直接胆红素、间接胆红素、肌酐、尿素氮、血清钾离子]水平。结果 406例新生儿疾病分布为新生儿呼吸窘迫综合征206例,新生儿黄疸105例,新生儿肺炎67例,新生儿溶血病11例,新生儿贫血7例,新生儿颅内出血3例,新生儿脓毒症3例,其他疾病4例。381例输注红细胞的新生儿中极早早产儿输注例数、次数及输注量均明显高于足月产儿、晚期早产儿、中期早产儿和早期早产儿,差异均有统计学意义(P<0.05);超低出生体质量儿输注例数、次数及输注量均明显高于正常体质量儿、低出生体质量儿和极低出生体质量儿,差异均有统计学意义(P<0.05)。73例输注血小板的新生儿中极早早产儿、超低出生体质量儿输注例数均明显高于其他组,差异均有统计学意义(P<0.05)。血液制剂输注后,新生儿血常规指标中Hb、HCT水平均明显高于输注前,而MCH、MCV水平均明显低于输注前,差异均有统计学意义(P<0.05);新生儿凝血指标中APTT水平明显低于输注前,差异有统计学意义(P<0.05);新生儿生化指标中总胆红素、直接胆红素、间接胆红素水平均高于输注前,而尿素氮水平明显低于输注前,差异均有统计学意义(P<0.05)。血液制剂输注前后,新生儿各指标中RDW、MCHC、INR、PT、肌酐、血清钾离子水平比较,差异均无统计学意义(P>0.05)。结论 新生儿呼吸窘迫综合征、新生儿黄疸及新生儿肺炎是新生儿输血的主要疾病。极早早产儿和超低出生体质量儿是新生儿输血的重要高风险人群,临床需严密监测患儿体征,尽早进行患儿血液管理,降低不良结局发生率。 展开更多
关键词 新生儿 输血 红细胞 血浆 冷沉淀 血小板
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输注不同配比冰冻血浆与红细胞对严重多发伤后HS患者凝血功能和预后的影响
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作者 张芍药 王艳琴 周林苹 《检验医学与临床》 2024年第3期329-332,337,共5页
目的探讨不同的冰冻血浆(FP)与红细胞(RBC)配比对严重多发伤后失血性休克(HS)患者凝血功能和预后的影响。方法选择该院2020年1月至2023年1月收治的严重多发伤后HS患者150例,随机分为A组、B组和C组,每组50例。A组给予FP∶RBC为1∶1的输... 目的探讨不同的冰冻血浆(FP)与红细胞(RBC)配比对严重多发伤后失血性休克(HS)患者凝血功能和预后的影响。方法选择该院2020年1月至2023年1月收治的严重多发伤后HS患者150例,随机分为A组、B组和C组,每组50例。A组给予FP∶RBC为1∶1的输血方案进行治疗,B组给予FP∶RBC为1∶2的输血方案进行治疗,C组给予FP∶RBC为1∶2.5的输血方案进行治疗。比较3组患者血液制品使用情况,输血前后凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆凝血酶时间(TT)和纤维蛋白原(FIB)]、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)T细胞)水平,以及两组预后情况。结果3组患者RBC和血小板使用量比较,差异均无统计学意义(P>0.05);A组患者FP使用量高于B、C组,B组FP使用量高于C组,差异均有统计学意义(P<0.05)。3组患者输血前PT、APTT、TT及FIB水平比较,差异均无统计学意义(P>0.05);3组患者输血后PT、APTT、TT均低于输血前,而FIB水平高于输血前,差异均有统计学意义(P<0.05);输血后,A组患者PT、APTT、TT均低于B、C组,而FIB水平高于B、C组,差异均有统计学意义(P<0.05);输血后,B组患者PT、APTT、TT均低于C组,而FIB水平高于C组,差异均有统计学意义(P<0.05)。3组患者输血前CD3^(+)、CD4^(+)、CD8^(+)T细胞百分比比较,差异均无统计学意义(P>0.05);输血后,A组患者CD3^(+)、CD4^(+)T细胞百分比均高于B、C组,而CD8^(+)T细胞百分比低于B、C组,差异均有统计学意义(P<0.05);输血后,B组患者CD3^(+)、CD4^(+)T细胞百分比高于C组,而CD8^(+)T细胞百分比低于C组,差异均有统计学意义(P<0.05)。3组病死率比较,差异无统计学意义(P>0.05)。A组存活患者并发症发生率低于B、C组,而B组存活患者并发症发生率低于C组,差异均有统计学意义(P<0.05)。结论严重多发伤后HS患者采用FP∶RBC配比为1∶1的输血方案最佳,不仅对患者免疫功能影响较小、有效改善患者凝血功能,还可以有效降低患者并发症发生率。 展开更多
关键词 血浆与红细胞配比 严重多发伤 失血性休克 凝血功能 免疫功能
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