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Antibody to the platelet factor 4/heparin complex is linked to the pathogenesis of HIT. However, there is insufficient information on anti-PF4/heparin antibody (HIT antibody) in cardiac surgery. In this study, we examined the occurrence of HIT and HIT antibody, seroconversion and the risk factors. We selected 28 patients who underwent cardiac procedure following catheterization within 3 months. An enzyme-linked immunosorbent assay (ELISA) for the antibody was measured using preoperative and postoperative serum samples. We could not identify patients with clinical HIT. The incidence of preoperative HIT antibody was 4%. Six of the 28 (21%) patients changed to positive postoperative assay from negative preoperative assay. Comparison of preoperative laboratory data and surgical details did not show significant differences between the patients with positive assays and those with negative assays on postoperative day 10, except total globulin. Preoperative total globulin of positive antibody assay was higher than that of negative antibody assay (2.89 ± 0.33 g/dl versus 2.42 ± 0.50 g/dl, p=0.030) and was related to positive postoperative antibody (p=0.048; odds ratio, 12.09; 95% confidence interval, 1.02-144.06). 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Risk Factor Analysis for Positive Postoperative Anti-platelet Factor 4/heparin Antibody in Cardiac Surgery
http://hdl.handle.net/10470/28051
http://hdl.handle.net/10470/280511b03d50a-67bc-4efc-8490-bfdb30ddd6e7
名前 / ファイル | ライセンス | アクション |
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KJ00006015084.pdf (584.5 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2010-08-10 | |||||
タイトル | ||||||
タイトル | Risk Factor Analysis for Positive Postoperative Anti-platelet Factor 4/heparin Antibody in Cardiac Surgery | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
別タイトル | ||||||
その他のタイトル | 心臓手術における抗PF4・ヘパリン複合体抗体に対する危険因子の検討 | |||||
著者名 |
WATANABE, Naruhito
× WATANABE, Naruhito× SAITO, Satoshi× SHIN'OKA, Toshiharu× KUROSAWA, Hiromi |
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著者別名 | ||||||
姓名 | 渡辺, 成仁 | |||||
著者別名 | ||||||
姓名 | 齋藤, 聡 | |||||
著者別名 | ||||||
姓名 | 新岡, 俊治 | |||||
著者別名 | ||||||
姓名 | 黒澤, 博身 | |||||
出版者 | ||||||
出版者 | 東京女子医科大学学会 | |||||
受付日付 | ||||||
日付 | 2010-08-10 | |||||
日付タイプ | Created | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 0040-9022 | |||||
NCID | ||||||
収録物識別子タイプ | NCID | |||||
収録物識別子 | AN00161368 | |||||
書誌情報 |
東京女子医科大学雑誌 巻 78, 号 12, p. 525-530, 発行日 2008-12 |
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著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | ヘパリン起因性血小板減少症(HIT)は,免疫機序で発生するヘパリンの重篤な合併症である.抗PF4・ヘパリン複合体抗体(HIT抗体)はHITの病因となるが,心臓外科領域において,その詳細は明らかではない.今回,カテーテル検査後3ヵ月以内に心臓手術を施行された計28例を対象とし,HIT・HIT抗体の発生率,HIT抗体のseroconversion・危険因子について検討した.HIT抗体は術前と術後にELISAを用いて測定した.全症例において臨床上明らかなHITは認めなかった.術前HIT抗体は28例中1例(4%)にみられ,28例中6例(21%)で術前HIT抗体陰性から術後陽性となった(seroconversion).術後HIT抗体陽性と陰性患者において術前検査結果と人工心肺時間などを比較検討した結果,総グロブリンのみが有意差を示した.術前総グロプリンは術後HIT抗体陽性群(2.89±0.33g/dl)において陰性群(2.42±0.50K/dl)より高値であった(p=0.030).また,術前総グロブリン値は術後HIT抗体陽性と関連性があった(p=0.048;オッズ比.12.09;95%信頼区間,1.02-144.06).Seroconversionの発生率は低く,術前総グロブリン高値は術後HIT抗体陽性の危険因子となる可能性があると考えられた. | |||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Heparin-induced thrombocytopenia (HIT) is a serious, immune system-mediated complication of heparin therapy. Antibody to the platelet factor 4/heparin complex is linked to the pathogenesis of HIT. However, there is insufficient information on anti-PF4/heparin antibody (HIT antibody) in cardiac surgery. In this study, we examined the occurrence of HIT and HIT antibody, seroconversion and the risk factors. We selected 28 patients who underwent cardiac procedure following catheterization within 3 months. An enzyme-linked immunosorbent assay (ELISA) for the antibody was measured using preoperative and postoperative serum samples. We could not identify patients with clinical HIT. The incidence of preoperative HIT antibody was 4%. Six of the 28 (21%) patients changed to positive postoperative assay from negative preoperative assay. Comparison of preoperative laboratory data and surgical details did not show significant differences between the patients with positive assays and those with negative assays on postoperative day 10, except total globulin. Preoperative total globulin of positive antibody assay was higher than that of negative antibody assay (2.89 ± 0.33 g/dl versus 2.42 ± 0.50 g/dl, p=0.030) and was related to positive postoperative antibody (p=0.048; odds ratio, 12.09; 95% confidence interval, 1.02-144.06). The rate of seroconversion was low, and elevated level of preoperative total globulin may be the risk factor for positive postoperative HIT antibody. | |||||
著者所属 | ||||||
Department of Cardiovascular Surgery, Tokyo Women's Medical University | ||||||
著者所属 | ||||||
Department of Cardiovascular Surgery, Tokyo Women's Medical University | ||||||
著者所属 | ||||||
Department of Cardiovascular Surgery, Tokyo Women's Medical University | ||||||
著者所属 | ||||||
Department of Cardiovascular Surgery, Tokyo Women's Medical University | ||||||
著者所属 | ||||||
東京女子医科大学心臓血管外科 | ||||||
著者所属 | ||||||
東京女子医科大学心臓血管外科 | ||||||
著者所属 | ||||||
東京女子医科大学心臓血管外科 | ||||||
著者所属 | ||||||
東京女子医科大学心臓血管外科 | ||||||
著者キーワード | ||||||
主題Scheme | Other | |||||
主題 | heparin-induced thrombocytopenia | |||||
著者キーワード | ||||||
主題Scheme | Other | |||||
主題 | anti-PF4 | |||||
著者キーワード | ||||||
主題Scheme | Other | |||||
主題 | heparin antibody | |||||
著者キーワード | ||||||
主題Scheme | Other | |||||
主題 | total globulin | |||||
著者キーワード | ||||||
主題Scheme | Other | |||||
主題 | cardiac surgery | |||||
著者キーワード | ||||||
主題Scheme | Other | |||||
主題 | seroconversion |