Changes of APTT,PT and FIB levels in patients with liver cirrhosis and upper gastrointestinal bleeding following allogeneic blood transfusion and their relationship with the prognosis
Objective To analyze the changes of activated partial thromboplastin time(APTT),prothrombin time(PT)and fibrinogen(FIB)levels in patients with liver cirrhosis and upper gastrointestinal bleeding after allogeneic transfusion,and their relationship with the prognosis.Methods The medical records of 122 patients with liver cirrhosis and upper gastrointestinal bleeding who received blood transfusions in the hospital from February 2021 to December 2023 were collected retrospectively.Based on prognosis,the patients were divided into two groups:the survival group(n=102)and the death group(n=20).General patient informa-tion,and plasma APTT,PT and FIB levels before blood transfusion and after 1 day of treatment were collected.The relationship between changes in APTT,PT and FIB levels and the prognosis was analyzed.Results The proportions of total transfusion of blood products,blood transfusion(plasma,cryoprecipitate),Child-Pugh grade C,shock,ascites,hepatic encephalopathy,and C-reactive protein level in the survival group were lower than those in the death group.The proportion of first gastrointestinal bleeding,mean arterial pressure and albu-min level in the survival group were higher than in the death group(P<0.05).After treatment,APTT and PT in both groups were longer than before treatment,and FIB levels were lower than before treatment.However,APTT and PT in the survival group were shorter than those in the death group,and FIB level was higher than in the death group(P<0.05).Logistic regression analysis found that Child-Pugh grade C,non-first gastrointestinal bleeding,shock,ascites,hepatic encephalopathy,and abnormal APTT and PT were risk factors for poor prog-nosis in patients with liver cirrhosis and upper gastrointestinal bleeding allogeneic transfusion,while abnormal elevated mean arterial pressure and FIB were protective factors for poor prognosis(P<0.05).Pearson correla-tion analysis found that the levels of APTT and PT in patients with non-first gastrointestinal bleeding and after blood transfusion treatment are positively correlated with their poor prognosis,while mean arterial pressure and FIB level were negatively correlated with poor prognosis(P<0.05).Conclusion The prognosis of allogeneic blood transfusion in patients with upper gastrointestinal bleeding and liver cirrhosis is influenced by the frequen-cy of gastrointestinal bleeding and the levels of APTT,PT and FIB after treatment.Changes of the above indica-tors can offer valuable insight for evaluating the prognosis of patients.
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