Predictive Value of Coagulation Factor Ⅷ Combined with Thromboelastography on Bleeding Risk of Patients with Acute Leukemia Chemotherapy and Myelosuppression
LIU Ren-mei, ZHANG Xin-bin
Department of Emergency Medicine,Shandong Provincial Third Hospital,Jinan Shandong 250031Shandong Provincial Third Hospital,Jinan Shandong 250031
Abstract 【Objective】 To explore the predictive value of coagulation factor Ⅷ (FⅧ) combined with thromboelastography (TEG) on the bleeding risk of patients with acute leukemia chemotherapy and myelosuppression. 【Methods】 A total of 86 patients with acute leukemia chemotherapy and myelosuppression were tested for the coagulation FⅧ level and TEG parameters [coagulation time (K value),reaction time (R value),maximum thrombosis (MA value) and blood clot aggregation rate (Angle value)]. According to the bleeding within 48 hours after bone marrow suppression,patients were divided into the bleeding group and no bleeding group. Logistic multivariate regression analysis was used to explore the related factors of bleeding in patients with acute leukemia chemotherapy for myelosuppression,and receiver operating characteristic curve (ROC) was used to determine the predictive value of TEG-related indicators and FⅧ levels in patients.【Results】 Among 86 patients with acute leukemia bone marrow suppression during chemotherapy,51 patients had bleeding (the bleeding group),accounting for 59.30% (51/86); the remaining 35 patients had no bleeding (non-bleeding group),accounting for 40.70% (35/86). The proportion of infected cases in the bleeding group was higher than that in the non-bleeding group,and the MA value and FⅧ level were lower than those in the bleeding group (P<0.05). Logistic multivariate regression analysis showed that co-infection and reduced-MA value and FⅧ level were risk factors for bleeding in patients (P<0.05). ROC analysis showed that the bleeding risk by the area under the curve (AUC) of MA value,FⅧ level and the combination of the two parameters were 0.744,0.724,and 0.848,respectively. MA value and FⅧ level alone predict the bleeding risk in patients,however,their predictive powers were lower than the combination of the two (P<0.05). 【Conclusion】 With the decrease of MA value and FⅧ level,the incidence of bleeding in acute leukemia myelosuppressed patients with co-infection increased significantly; MA value and FⅧ level have a certain clinical predictive value for bleeding in patients.
LIU Ren-mei,ZHANG Xin-bin. Predictive Value of Coagulation Factor Ⅷ Combined with Thromboelastography on Bleeding Risk of Patients with Acute Leukemia Chemotherapy and Myelosuppression[J]. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 848-851.
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2023, Vol. 40 
