Analysis of laboratory parameters and death risk in patients with thrombotic thrombocytopenic purpura
10.3760/cma.j.cn114452-20220607-00334
- VernacularTitle:血栓性血小板减少性紫癜患者的实验室指标与死亡风险分析
- Author:
Ming HUANG
1
;
Ning TANG
;
Chi ZHANG
;
Guo LI
;
Hui ZHANG
;
Jiaoyuan LI
;
Yang FEI
Author Information
1. 华中科技大学同济医学院附属同济医院检验科，武汉 430030
- Keywords:
Thrombotic thrombocytopenic purpura;
Von Willebrand factor cleaving protease 13;
Death risk analysis
- From:
Chinese Journal of Laboratory Medicine
2022;45(10):1076-1082
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the laboratory parameters and clinical characteristics of TTP patients, so as to provide reference for the timely diagnosis and death risk assessment or TTP.Methods:83 patients with TTP from June 2016 to March 2022 in our hospital were analyzed retrospectively. They were divided into survival and death groups. The differences in general information, clinical symptoms and laboratory parameters were compared between the two groups. The prognostic prediction score was constructed by combining parameters which differ between the two groups to calculate the corresponding mortality risk.Results:83 patients were included in the study, of whom 81.1% (60/74), 91.1% (72/79) and 86.2% (50/58) had increased AST, IBIL and cTnI results, and all (78/78) had higher LDH at admission. Hb was decreased in 97.5% (79/81) patients, and PLT of 97.5% (79/81) patients was less than 30×10 9/L. There were no significant differences in gender, age, blood type, presence of fever, ADAMTS-13 activity and PLASMIC score between the survival group (58 cases) and the death group (25 cases), but the proportion of neurologic symptoms in the death group was significantly higher than that in the survival group. AST, IBIL, cTnI and APTT at admission were significantly higher in the death group than in the survival group ( P<0.05). The risk of death was 4.86, 9.74, 3.71, and 5.33 for those with high AST, IBIL, APTT, and cTnI levels, respectively, compared with those with low levels at admission. At last, AST, IBIL, APTT, cTnI and neurological symptoms were included to construct a score model. For each 1 point increase, the risk of short-term death in TTP patients was 3.24. Conclusions:Multiple laboratory markers have high negative exclusion value for TTP. For TTP patients with high AST, IBIL, cTnI and APTT and neurologic symptoms, more attention and active treatment should be paid to reduce mortality.
