Objective: Assessment of thromboela-stography (TEG) as a monitoring approach for coagulation changes and as a predictor of treatment efficacy in the management of slowly progressive ACLF with DPMAS combined with PE. Methods: A total of forty-nine patients with slowly progressive acute liver failure treated with DPMAS combined with PE in the General Hospital of Ningxia Medical University were collected. TEG and routine coagulation parameters were assessed before and after treatment, and relevant clinical data and coagulation indices,including prothrombin time(PT)、activated partial thromboplastin time(APTT)、international normalized ratio(INR)、plasma fibrinogen(FIB) were collected for statistical analysis. Pearson's method was applied to explore potential correlations between TEG-derived metrics and traditional coagulation indicators. In addition, ROC analysis was conducted to determine the capacity of TEG parameters, both alone and in combination, to predict clinical outcomes in ACLF patients. Results: Compared with pre-treatment levels, patients treated with DPMAS combined with PE showed significant improvements in clinical characteristics and laboratory indicators (P＜0.05) . TEG test results showed a significant decrease in R-value and a significant increase in coagulation index (P=0.001); conventional coagulation tests PT, APTT, INR, and FIB indexes improved significantly, with statistical significance (all P＜0.01). R was found to be positively linked to PT, APTT, and INR, while K showed a negative correlation with PLT and FIB, with all relationships reaching statistical significance (P＜0.05). The AUC of TEG parameters for predicting patient prognosis was significantly higher than that of single-item evaluation(P＜0.01), with a sensitivity of 75.85% and a specificity of 92.17%. Conclusion: In patients with ACLF receiving DPMAS combined with PE, dynamic coagulation profiles assessed by TEG were more reflective of clinical status than conventional indicators and exhibited superior predictive capability regarding outcomes.
MA Wanlong
,
LIU Shuaiwei
,
LIU Huijuan
,
HAI Long
,
LUO Xia
,
ZHANG Ping
,
JIAO Yun
,
DING Xiangchun
. The thromboela-stography application value in the treatment of acute-on-chronic liver failure by double plasma molecular adsorpiion system combined with plasma exchange[J]. Journal of Baotou Medical College, 2025
, 41(8)
: 55
-60
.
DOI: 10.16833/j.cnki.jbmc.2025.08.010
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