| Objective To investigate the changes of coagulation function and prognosis in patients with carbon monoxide poisoning (ACOP) with different levels of poisoning. Methods A total of 61 patients with ACOP admitted to the No. 371 Central Hospital of the Chinese People's Liberation Army from January 2015 to December 2017 were divided into mild group (35 cases) and middle group (26 cases) according to the diagnosis and classification criteria of carbon monoxide poisoning. Thirty healthy subjects of the same physical examination were selected as control group. The ICU hospitalization time (d), mechanical ventilation time (d), and carboxyhemoglobin content (%) were compared among the three groups. While the conventional coagulation parameters prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer (DD), fibrin (original) degradation products (FDP), and thromboelastogram (TEG) indicators, coagulation reaction time (R), clot formation time (K), hemagglutination rate (Angle angle), clot strength (MA), the hemagglutination composite index (CI) were detected and compared in three groups, then the correlation between the indicators was analysed. All patients with ACOP were followed up for 28 days. According to the prognosis, the patients were divided into survival group (42 cases) and death group (19 cases). The coagulation function of the two groups was evaluated and compared. Results There were significant differences in ICU hospitalization time (d), mechanical ventilation time (d), carboxyhemoglobin content (%) between two groups (P<0.05). The difference in routine coagulation function index and TEG index between three groups was statistically significant (P<0.05). PT, APTT, and TT of patients with recombination were shorter than those of mild group (P<0.05), and the levels of DD and FDP were higher than those of mild group (P<0.05). There was no significant difference in FIB between two groups (P>0.05). Compared with survival group, PT, APTT and TT were significantly shortened, and the levels of FIB, D-D and FDP significantly increased in death group, and the differences were statistically significant (P<0.05). Among the TEG indicators, R value was significantly shorter (P<0.05) and MA value was significantly higher in mild group compared with control group (P<0.05). R and K values of the patients with middle recombination were significantly shorter (P<0.05), and Angle angle, MA value and CI value markedly increased (P<0.05). Compared with survival group, R and K values were significantly shorter (P<0.05), and the Angle, MA and CI values were significantly higher (P<0.05). R value in TEG detection was positively correlated with PT and APTT (P<0.05); K value was positively correlated with APTT (P<0.05), and negatively correlated with FIB (P<0.05); Angle was negatively correlated with APTT (P<0.05), and positively correlated with FIB and DD (P<0.05); MA value was positively correlated with FIB (P<0.05); CI value was negatively correlated with PT and APTT (P<0.05), and positively correlated with FIB (P<0.05). Conclusion With the increase of poisoning degree, the coagulation function of ACOP patients is hypercoagulable, and the degree of coagulation disorder is related to the severity of patient condition. The conventional coagulation function index has a correlation with the thromboelastography index, and both have guiding significance for monitoring the coagulation function of ACOP patients. |
