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抗凝治疗对重症新型冠状病毒感染患者28d预后的价值

曹玲玲 张燕媚 查万杰 周媛 欧啟添 黄绮雯 李俊德 温妙云 钟文宏

实用医学杂志2023,Vol.39Issue(21):2730-2735,6.
实用医学杂志2023,Vol.39Issue(21):2730-2735,6.DOI:10.3969/j.issn.1006-5725.2023.21.007

抗凝治疗对重症新型冠状病毒感染患者28d预后的价值

Value of prophylactic anticoagulation therapy in the 28-day prognosis of severe COVID-19 patients

曹玲玲 1张燕媚 1查万杰 1周媛 1欧啟添 1黄绮雯 1李俊德 1温妙云 1钟文宏1

作者信息

  • 1. 南方医科大学附属广东省人民医院,广东省医学科学院重症医学科 (广州 510080)
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摘要

Abstract

Objective To explore the value of prophylactic anticoagulation in the 28-day prognosis of patients with severe COVID-19.Methods The clinical data of COVID-19 patients admitted to Guangdong Provincial People's Hospital from December 2022 to January 2023 were collected,including age,gender,past medical history,routine blood test,liver and renal function,procalcitonin,coagulation function,Padua prediction score,antiviral therapy,hormonotherapy,immunotherapy and anticoagulation therapy.The patients were divided into an anticoagula-tion group and a non-anticoagulation group.The differences in various indicators were compared between the two groups.Cox regression was performed to assess the independent risk factors for 28-day mortality and the anticoagula-tion efficacy between the subgroups.Results Among 158 patients,128 received anticoagulation;There were significant differences between the two groups in case number of hypertension and critical condition,lymphocyte count,prothrombin time,D-dimer,and case number of immunotherapy.COX logistic regression showed that antico-agulation(HR = 2.25,95%CI:1.01~5.01,P = 0.048)was an independent risk factor for all-cause mortality of COVID-19 patients within 28 days.Subgroup analysis showed that anticoagulation therapy led to an increase in the 28-day mortality as level of procalcitonin of≥0.5 pg/mL(HR = 2.72,95%CI:1.05~7.04)or D-dimer of<2 000 ng/mL(HR = 9.16,95%CI:1.63~51.48).Conclusions Prophylactic anticoagulation did not reduce all-cause mortality of COVID-19 within 28 days.

关键词

重症/新型冠状病毒肺炎/预防性抗凝治疗/预后

Key words

severe/COVID-19/prophylactic anticoagulation/prognosis

分类

医药卫生

引用本文复制引用

曹玲玲,张燕媚,查万杰,周媛,欧啟添,黄绮雯,李俊德,温妙云,钟文宏..抗凝治疗对重症新型冠状病毒感染患者28d预后的价值[J].实用医学杂志,2023,39(21):2730-2735,6.

基金项目

广州地区临床高新、重大、特色技术项目(编号:2023P-TS25) (编号:2023P-TS25)

实用医学杂志

OA北大核心CSTPCD

1006-5725

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