Serum Concentrations of Angiopoietin-2 and Soluble fms-Like Tyrosine Kinase 1 (sFlt-1) Are Associated with Coagulopathy among Patients with Acute Pancreatitis.
Serum Concentrations of Angiopoietin-2 and Soluble fms-Like Tyrosine Kinase 1 (sFlt-1) Are Associated with Coagulopathy among Patients with Acute Pancreatitis.
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DOI：
10.3390/ijms18040753
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发表时间：
2017-04-02
影响因子：
5.6
通讯作者：
Drożdż R
中科院分区：
文献类型：
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作者：
Dumnicka P;Kuśnierz-Cabala B;Sporek M;Mazur-Laskowska M;Gil K;Kuźniewski M;Ceranowicz P;Warzecha Z;Dembiński A;Bonior J;Drożdż R
在重症急性胰腺炎（SAP）中，全身炎症导致内皮功能障碍和凝血激活。急性胰腺炎（AP）的血栓性疾病包括弥散性血管内凝血（DIC）。最近，血管生成素-2和可溶性fms样酪氨酸激酶1（sFlt-1）被认为是急性状态下内皮功能障碍的标志物。我们的目的是评估在AP的早期阶段凝血异常的频率和评估血清血管生成素-2和sFlt-1和凝血功能障碍的严重程度之间的关系。招募了69例成人AP患者：5例SAP，15例中重度AP（MSAP）和49例轻度AP。根据国际血栓与止血学会（ISTH）评分，6例患者被诊断为DIC。所有患者至少有一项常规止血检查结果异常（血小板计数低、凝血时间延长、纤维蛋白原降低和D-二聚体升高）。根据2012年亚特兰大标准，凝血功能障碍的严重程度与AP严重程度、AP严重程度的床旁指数和住院时间相关。D-二聚体与C-反应蛋白独立相关，并研究了内皮功能障碍的标志物。Angiopoietin-2、D-二聚体和ISTH评分是SAP的最佳预测因子，而sFlt-1是MSAP合并SAP的良好预测因子。在临床实践中，常规止血检查可能有助于AP的预后。
In severe acute pancreatitis (SAP), systemic inflammation leads to endothelial dysfunction and activation of coagulation. Thrombotic disorders in acute pancreatitis (AP) include disseminated intravascular coagulation (DIC). Recently, angiopoietin-2 and soluble fms-like tyrosine kinase 1 (sFlt-1) were proposed as markers of endothelial dysfunction in acute states. Our aim was to assess the frequency of coagulation abnormalities in the early phase of AP and evaluate the relationships between serum angiopoietin-2 and sFlt-1 and severity of coagulopathy. Sixty-nine adult patients with AP were recruited: five with SAP, 15 with moderately severe AP (MSAP) and 49 with mild AP. Six patients were diagnosed with DIC according to International Society on Thrombosis and Haemostasis (ISTH) score. All patients had at least one abnormal result of routine tests of hemostasis (low platelet count, prolonged clotting times, decreased fibrinogen, and increased D-dimer). The severity of coagulopathy correlated with AP severity according to 2012 Atlanta criteria, bedside index of severity in AP and duration of hospital stay. D-dimers correlated independently with C-reactive protein and studied markers of endothelial dysfunction. Angiopoietin-2, D-dimer, and ISTH score were best predictors of SAP, while sFlt-1 was good predictor of MSAP plus SAP. In clinical practice, routine tests of hemostasis may assist prognosis of AP.