지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2011.1
- 수록면
- 1 - 8 (8page)
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Background: Heparin-induced thrombocytopenia (HIT) is an adverse drug reaction caused by antibodies to the heparin/platelet factor 4 (PF4) complex, resulting in thrombocytopenia and prothrombotic state. HIT diagnosis is challenging and depends on clinical presentation and laboratory tests. We investigated the usefulness of clinical scores and heparin/PF4 ELISA optical density (OD) as a diagnostic marker and thrombosis predictor in HIT.
Methods: We analyzed 92 patients with suspected HIT. The heparin/PF4 antibody was measured using a commercial ELISA kit (GTI,USA). For each patient, the 4 T’s score and Chong’s score were calculated.
Results: Of the 92 patients, 28 were anti-heparin/PF4-seropositive. The 4 T’s score and Chong’s score showed good correlation (r=0.874). The 4 T’s score and OD values showed good performance for diagnosis of the definite and unlikely HIT groups; however, OD levels showed better sensitivity (93.8%) than the 4 T’s score used alone (62.5%). Of the 92 patients, 26 developed thrombosis. The OD values were significantly higher in patients with thrombosis than in those without thrombosis (0.52 vs. 0.22, P<0.001). Patients with high OD values (OD>0.4) had an increased risk of thrombosis (adjusted odds ratio 9.44 [3.35–26.6], P<0.001) and a shorter 250-day thrombosis-free survival (32.1% vs. 54.7%, P=0.012).
Conclusions: ELISA OD values in combination with clinical scoring can improve the diagnosis of and thrombosis prediction in HIT. More attention should be paid to the use of clinical scores and OD values as thrombosis predictors in HIT.
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참고문헌 (16)
참고문헌 신청
Greinacher A / 2006 / Recognition, treatment, and prevention of heparin-induced thrombocytopenia: review and update / Thromb Res 118:165~176
Chong BH / 2004 / Heparin-induced thrombocytopenia / Expert Rev Cardiovasc Ther 2:547~559
Warkentin TE / 2003 / Laboratory diagnosis of immune heparin-induced thrombocytopenia / Curr Hematol Rep 2:148~157
Lo GK / 2006 / Evaluation of pretest clinical score(4 T’s)for the diagnosis of heparin-induced thrombocytopenia in two clinical settings / J Thromb Haemost 4:759~765
Greinacher A / 2007 / Heparin-induced thrombocytopenia: a prospective study on the incidence, platelet-activating capacity and clinical significance of antiplatelet factor 4/heparin antibodies of the IgG, IgM, and IgA classes / J Thromb Haemost 5:1666~1673
Chong BH / 2004 / Heparin-induced thrombocytopenia / Expert Rev Cardiovasc Ther 2:547~559
Warkentin TE / 2003 / Laboratory diagnosis of immune heparin-induced thrombocytopenia / Curr Hematol Rep 2:148~157
Lo GK / 2006 / Evaluation of pretest clinical score(4 T’s)for the diagnosis of heparin-induced thrombocytopenia in two clinical settings / J Thromb Haemost 4:759~765
Greinacher A / 2007 / Heparin-induced thrombocytopenia: a prospective study on the incidence, platelet-activating capacity and clinical significance of antiplatelet factor 4/heparin antibodies of the IgG, IgM, and IgA classes / J Thromb Haemost 5:1666~1673
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