BACKGROUND Von-Willebrand factor(vWF)disposes certain prognostic value in patients with liver cirrhosis,but its relation to other prognostic indicators has not been fully investigated.AIM To analyze the relation betwe...BACKGROUND Von-Willebrand factor(vWF)disposes certain prognostic value in patients with liver cirrhosis,but its relation to other prognostic indicators has not been fully investigated.AIM To analyze the relation between vWF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality.METHODS This analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension.It analyzed the relation between vWF and the stage of the disease and several inflammatory and prognostic indicators.The prospective analysis,performed on a sample of 63 patients,evaluated the association between the selected variables[vWF,Model for End-stage Liver Disease(MELD)score,C-reactive protein(CRP),ferritin,vitamin D,activated partial thromboplastin time,thrombin time,D-dimer concentration]and the survival time as well as their predictive value in terms of 3-mo,6-mo and 1-year mortality.RESULTS vWF was significantly higher in patients with higher Child-Turcotte-Pugh class(P=0.0045),MELD group(P=0.0057),ferritin group(P=0.0278),and D-dimer concentration(P=0.0232).vWF significantly correlated with D-dimer concentration,ferritin,CRP,International Normalized Ratio,and MELD,Child-Turcotte-Pugh,Sequential Organ Failure Assessment,and CLIF-consortium organ failure(CLIF-C OF)scores.vWF,MELD score,and CRP were significantly associated with death and were significant predictors of 3-mo,6-mo,and 1-year mortality.Each vWF unit significantly increased the probability for 3-mo mortality by 1.005 times(P=0.008),for 6-mo mortality by 1.006 times(P=0.005),and for 1-year mortality by 1.007 times(P=0.002).There was no significant difference between the diagnostic performance of vWF and MELD score and also between vWF and CRP regarding the 3-mo,6-mo,and 1-year mortality.CONCLUSION In patients with liver cirrhosis,vWF is significantly related to other prognostic indicators and is a significant predictor of 3-mo,6-mo,and 1-year mortality similar to MELD score and CRP.展开更多
Objective: To investigate the change of serum inflammatory factors, von Willebrand factor (vWf), vascular endothelial growth factor (VEGF) and adhesion molecule levels in diabetic nephropathy patients (DN), and their ...Objective: To investigate the change of serum inflammatory factors, von Willebrand factor (vWf), vascular endothelial growth factor (VEGF) and adhesion molecule levels in diabetic nephropathy patients (DN), and their significance in the detection of diabetic nephropathy. Methods: According to urinary albumin excretion rate (UAER), a total of 158 cases of diabetic patients were divided into T2DM group (Simple diabetes group, n=52) and DN group (diabetic nephropathy group, n=106), group DN were divided into microalbuminuria group (n=54) and macroalbuminuria group (n=52);At the same time, 50 healthy subjects were selected as control group, the levels of serum inflammatory factors (hs-CRP, IL-6 and TNF-α), vWf, VEGF and adhesion molecules (sVCAM-1, sICAM-1 and E- selectin) in these four groups were compared. Results: The levels of hs-CRP, IL-6, vWf, VEGF, TNF-α, sVCAM-1, sICAM-1 and E- selectin in the T2DM group and DN group were significantly higher than those in the control group, and DN group was significantly higher than that in T2DM group, the difference was statistically significant;In the DN group, compared with microalbuminuria group, the levels of hs-CRP, IL-6, vWf, VEGF, TNF-α, sVCAM-1, sICAM-1 and E- selectin in the macroalbuminuria group were significantly increased, the difference was statistically significant. Conclusion: Serum inflammatory factors, vWf, VEGF and adhesion molecules may play important roles in the course of the genesis and development of DN. It has great value to the assessment of this disease.展开更多
目的本研究旨在研究和探讨血管性血友病因子（von Willebrand factor，vwF）和含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶（A disintegrin—like and metalloprotease with thrombospondin type 1 motif，vWF裂解酶，ADAMTS13）...目的本研究旨在研究和探讨血管性血友病因子（von Willebrand factor，vwF）和含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶（A disintegrin—like and metalloprotease with thrombospondin type 1 motif，vWF裂解酶，ADAMTS13）的活性在感染性休克和脓毒症患者早期及预后评估方面的临床意义。方法选取2012—06—2013—06收住无锡市人民医院ICU的感染性休克或脓毒症患者40例，根据预后分为存活组20例和死亡组20例，记录其一般情况及入组时APACHE11评分，于发病第1、3、5、7天分别运用ELISA法检测其血浆vWF活性及ADAMTS13活性，各样本均数用方差分析、受试者工作特征（receiver operating characteristic，ROC）曲线分析、参数间进行Spearman相关分析，并绘制ROC曲线探讨vWF活性、ADAMTS13活性与APACHE Ⅱ评分之间的相关性。结果死亡组的vWF活性均明显高于存活组（P〈0．05），ADAMTS13活性明显低于存活组（P〈0．05）；同时死亡组APACHEⅡ评分明显高于存活组（P〈0．05）；存活组在第3天vwF活性升高、ADAMTS13活性下降、APACHEⅡ评分升高，而在第5天和第7天又出现vWF活性持续下降、ADAMTS13活性持续升高、APACHEⅡ评分持续下降，死亡组则呈现vWF活性持续上升、ADAMTS13活性持续下降、APACHEⅡ评分持续升高（P〈0．05）。40例患者的平均vWF活性与APACHEⅡ评分呈正相关（P〈0．01），而ADAMTS13活性与APACHEⅡ评分呈负相关（P〈0．01）：ROC曲线分析，vWF活性和ADAMTS13活性AUC均接近于1，提示能很好地预测患者的预后（P〈0．01）。结论vWF活性、ADAMTS13活性均是判断感染性休克和脓毒症患者预后的可靠指标。在脓毒症的病理过程中，此二者数值的变化与疾病严重程度密切相关，即vWF活性的升高、ADAMTS13活性的降低预示了患者预后差。展开更多
目的 探讨急性心肌梗死（AMI）患者入院时血浆血管性血友病因子（vWF）水平与急诊经皮冠状动脉介入治疗（PCI）后无复流现象发生的关系以及对近期预后的影响.方法 急诊PCI治疗的AMI患者103例,依据术后血管造影TIMI血流分级和心肌呈色分...目的 探讨急性心肌梗死（AMI）患者入院时血浆血管性血友病因子（vWF）水平与急诊经皮冠状动脉介入治疗（PCI）后无复流现象发生的关系以及对近期预后的影响.方法 急诊PCI治疗的AMI患者103例,依据术后血管造影TIMI血流分级和心肌呈色分级（MBG）分为两组,冠状动脉前向血流〈TIMIⅢ级或TIMIⅢ级但MBG〈2级者38例为无复流组,余65例为再灌注组,另以20例健康人为对照组.于急诊入院时采集静脉血,采用ELISA测定血浆vWF的含量.采用Logistic回归分析影响患者PCI术后无复流发生的因素. 结果 再灌注组和无复流组血浆vWF水平明显高于对照组（ P 均〈0.05）,无复流组血浆vWF水平高于再灌注组（ P 〈0.05）；计算得出所有患者入院时血浆vWF水平25、50、75百分位数分别为120%、150%、180%.Logistic回归分析显示,入院时血浆vWF水平≥180%（ P =0.003）、血小板平均体积（ P =0.002）及中性粒细胞计数（ P =0.049）是AMI患者PCI后心肌无复流发生的独立危险因素;入院时血浆vWF水平≥ 180%组与〈180%组相比,无复流发生比例增加（ P =0.002）,住院期间主要心血管事件（MACE）的发生增加（ P =0.027）,平均住院时间延长（ P =0.037）.结论 入院时血浆vWF水平是预测AMI患者PCI后心肌无复流的独立危险因素,与AMI患者PCI后无复流发生、住院期间MACE发生、平均住院天数相关,对于PCI后AMI患者的预后评价有一定的临床意义.展开更多
文摘BACKGROUND Von-Willebrand factor(vWF)disposes certain prognostic value in patients with liver cirrhosis,but its relation to other prognostic indicators has not been fully investigated.AIM To analyze the relation between vWF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality.METHODS This analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension.It analyzed the relation between vWF and the stage of the disease and several inflammatory and prognostic indicators.The prospective analysis,performed on a sample of 63 patients,evaluated the association between the selected variables[vWF,Model for End-stage Liver Disease(MELD)score,C-reactive protein(CRP),ferritin,vitamin D,activated partial thromboplastin time,thrombin time,D-dimer concentration]and the survival time as well as their predictive value in terms of 3-mo,6-mo and 1-year mortality.RESULTS vWF was significantly higher in patients with higher Child-Turcotte-Pugh class(P=0.0045),MELD group(P=0.0057),ferritin group(P=0.0278),and D-dimer concentration(P=0.0232).vWF significantly correlated with D-dimer concentration,ferritin,CRP,International Normalized Ratio,and MELD,Child-Turcotte-Pugh,Sequential Organ Failure Assessment,and CLIF-consortium organ failure(CLIF-C OF)scores.vWF,MELD score,and CRP were significantly associated with death and were significant predictors of 3-mo,6-mo,and 1-year mortality.Each vWF unit significantly increased the probability for 3-mo mortality by 1.005 times(P=0.008),for 6-mo mortality by 1.006 times(P=0.005),and for 1-year mortality by 1.007 times(P=0.002).There was no significant difference between the diagnostic performance of vWF and MELD score and also between vWF and CRP regarding the 3-mo,6-mo,and 1-year mortality.CONCLUSION In patients with liver cirrhosis,vWF is significantly related to other prognostic indicators and is a significant predictor of 3-mo,6-mo,and 1-year mortality similar to MELD score and CRP.
文摘Objective: To investigate the change of serum inflammatory factors, von Willebrand factor (vWf), vascular endothelial growth factor (VEGF) and adhesion molecule levels in diabetic nephropathy patients (DN), and their significance in the detection of diabetic nephropathy. Methods: According to urinary albumin excretion rate (UAER), a total of 158 cases of diabetic patients were divided into T2DM group (Simple diabetes group, n=52) and DN group (diabetic nephropathy group, n=106), group DN were divided into microalbuminuria group (n=54) and macroalbuminuria group (n=52);At the same time, 50 healthy subjects were selected as control group, the levels of serum inflammatory factors (hs-CRP, IL-6 and TNF-α), vWf, VEGF and adhesion molecules (sVCAM-1, sICAM-1 and E- selectin) in these four groups were compared. Results: The levels of hs-CRP, IL-6, vWf, VEGF, TNF-α, sVCAM-1, sICAM-1 and E- selectin in the T2DM group and DN group were significantly higher than those in the control group, and DN group was significantly higher than that in T2DM group, the difference was statistically significant;In the DN group, compared with microalbuminuria group, the levels of hs-CRP, IL-6, vWf, VEGF, TNF-α, sVCAM-1, sICAM-1 and E- selectin in the macroalbuminuria group were significantly increased, the difference was statistically significant. Conclusion: Serum inflammatory factors, vWf, VEGF and adhesion molecules may play important roles in the course of the genesis and development of DN. It has great value to the assessment of this disease.
文摘目的本研究旨在研究和探讨血管性血友病因子（von Willebrand factor，vwF）和含Ⅰ型血小板结合蛋白基序的解聚蛋白样金属蛋白酶（A disintegrin—like and metalloprotease with thrombospondin type 1 motif，vWF裂解酶，ADAMTS13）的活性在感染性休克和脓毒症患者早期及预后评估方面的临床意义。方法选取2012—06—2013—06收住无锡市人民医院ICU的感染性休克或脓毒症患者40例，根据预后分为存活组20例和死亡组20例，记录其一般情况及入组时APACHE11评分，于发病第1、3、5、7天分别运用ELISA法检测其血浆vWF活性及ADAMTS13活性，各样本均数用方差分析、受试者工作特征（receiver operating characteristic，ROC）曲线分析、参数间进行Spearman相关分析，并绘制ROC曲线探讨vWF活性、ADAMTS13活性与APACHE Ⅱ评分之间的相关性。结果死亡组的vWF活性均明显高于存活组（P〈0．05），ADAMTS13活性明显低于存活组（P〈0．05）；同时死亡组APACHEⅡ评分明显高于存活组（P〈0．05）；存活组在第3天vwF活性升高、ADAMTS13活性下降、APACHEⅡ评分升高，而在第5天和第7天又出现vWF活性持续下降、ADAMTS13活性持续升高、APACHEⅡ评分持续下降，死亡组则呈现vWF活性持续上升、ADAMTS13活性持续下降、APACHEⅡ评分持续升高（P〈0．05）。40例患者的平均vWF活性与APACHEⅡ评分呈正相关（P〈0．01），而ADAMTS13活性与APACHEⅡ评分呈负相关（P〈0．01）：ROC曲线分析，vWF活性和ADAMTS13活性AUC均接近于1，提示能很好地预测患者的预后（P〈0．01）。结论vWF活性、ADAMTS13活性均是判断感染性休克和脓毒症患者预后的可靠指标。在脓毒症的病理过程中，此二者数值的变化与疾病严重程度密切相关，即vWF活性的升高、ADAMTS13活性的降低预示了患者预后差。
文摘目的 探讨急性心肌梗死（AMI）患者入院时血浆血管性血友病因子（vWF）水平与急诊经皮冠状动脉介入治疗（PCI）后无复流现象发生的关系以及对近期预后的影响.方法 急诊PCI治疗的AMI患者103例,依据术后血管造影TIMI血流分级和心肌呈色分级（MBG）分为两组,冠状动脉前向血流〈TIMIⅢ级或TIMIⅢ级但MBG〈2级者38例为无复流组,余65例为再灌注组,另以20例健康人为对照组.于急诊入院时采集静脉血,采用ELISA测定血浆vWF的含量.采用Logistic回归分析影响患者PCI术后无复流发生的因素. 结果 再灌注组和无复流组血浆vWF水平明显高于对照组（ P 均〈0.05）,无复流组血浆vWF水平高于再灌注组（ P 〈0.05）；计算得出所有患者入院时血浆vWF水平25、50、75百分位数分别为120%、150%、180%.Logistic回归分析显示,入院时血浆vWF水平≥180%（ P =0.003）、血小板平均体积（ P =0.002）及中性粒细胞计数（ P =0.049）是AMI患者PCI后心肌无复流发生的独立危险因素;入院时血浆vWF水平≥ 180%组与〈180%组相比,无复流发生比例增加（ P =0.002）,住院期间主要心血管事件（MACE）的发生增加（ P =0.027）,平均住院时间延长（ P =0.037）.结论 入院时血浆vWF水平是预测AMI患者PCI后心肌无复流的独立危险因素,与AMI患者PCI后无复流发生、住院期间MACE发生、平均住院天数相关,对于PCI后AMI患者的预后评价有一定的临床意义.
