Antithrombin deficiency and its relationship to severe burns
Antithrombin deficiency and its relationship to severe burns
复制标题
DOI：
10.1016/j.burns.2006.06.011
复制
发表时间：
2007-03-01
期刊：
影响因子：
2.7
通讯作者：
Andel, H.
中科院分区：
文献类型：
--
作者：
Niedermayr, M.;Schramm, W.;Andel, H.
抗凝血酶（AT）是一种重要的内源性抗凝剂，具有显著的抗炎作用，为探讨AT缺乏症在严重烧伤中的发生率及其与烧伤严重程度指数（ABSI）、住院时间（LOS）和死亡率的相关性，我们收集了201例严重烧伤患者的AT替代资料。108例患者（54%）在住院期间发生AT缺乏症，根据我们的机构实践，通过连续输注接受替代治疗以维持生理血浆活性（70-120%）。平均给药剂量作为AT缺乏的指标。AT缺乏状态的患者百分比在损伤后的前5天内最高。采用多元回归分析方法，以AT浓缩物的平均给药剂量为因变量，以年龄、烧伤总表面积（TBSA）、性别、吸入性损伤（INHAL）、全层烧伤（FTB）、住院时间（LOS）和死亡率为自变量，进行多因素回归分析。年龄、性别和胎龄对AT缺陷的发生无明显影响。增加TBSA和INHAL明显增加AT缺乏的风险（p值0.0001和0.037）。该分析还确定AT缺乏是LOS和死亡率的独立预测因子（p值0.036和0.003）AT缺乏的发展是烧伤后的常见事件，与TBSA和INHAL显著相关，死亡率增加，住院时间延长。(c)2006年Elsevier Ltd和ISBI。All rights reserved.
Antithrombin (AT) is an important endogenous anticoagulant and exhibits marked anti-inflammatory properties.To evaluate the incidence of AT deficiency in severe burn and its correlation to the variables of the abbreviated burn severity index (ABSI), length of hospital stay (LOS) and mortality we collected data on the substitution of human plasma-derived AT concentrate in 201 consecutive patients suffering from severe burn. One hundred and eight patients (54%) developed AT deficiency during their hospitalisation and, according to our institutional practice, received substitution therapy by continuous infusion to maintain physiological plasma activity (70-120%). The mean administered dose served as a measure of AT deficiency. The percentage of patients in an AT deficient state was highest within the first 5 days after injury. It was 26% on day 1 and between 38% and 41% on days 2-5 and thereafter decreased constantly over time.A multiple regression analysis between the dependent variable mean administered dose of AT concentrate and the independent variables age, total body surface area burned (TBSA), gender, inhalation injury (INHAL), full thickness burn (FTB), LOS and mortality was performed. Age, gender and FTB showed no significant influence on the development of AT deficiency. Increasing TBSA and INHAL clearly increase the risk of developing AT deficiency (p-values 0.0001 and 0.037). The analysis also identified AT deficiency as an independent predictor of LOS and mortality (p-values 0.036 and 0.003).Development of AT deficiency is a frequent event after burn with significant correlation to TBSA and INHAL, increased mortality rates and longer hospital stays. (c) 2006 Elsevier Ltd and ISBI. All rights reserved.