ĐẶC ĐIỂM CHỈ SỐ PHÂN TÍCH DẠNG SÓNG CỤC MÁU ĐÔNG – CWA Ở BỆNH NHÂN SUY GAN CẤP

Abstract

Objetive: To describe the characteristics of clot waveform analysis (CWA) in patients with acute liver failure (ALF). Subjects and Methods: A study was carried on 40 patients with acute liver failure (ALF) treated at the Center for Critical care medicine of Bach Mai Hospital from July 2023 to July 2024. Blood samples were collected at the time of admission to the center before the use of anticoagulants and were analyzed using the CS 5100 machine and Dade Actin FSL reagent. The values of the clot waveform analysis (CWA), including min1, min2, max2, and waveform shape, were recorded. CWA data was analysed for the correalation with severity on admission by using medical statistical software. Results: The male ratio was higher than female, accounting for 70%, with an average age of 55.2 ± 15.5 (23-82). 18 patients with ACLF1 accounted for 45%, 10 patients with ACLF2 accounted for 25%, and ACLF3 accounted for 30%. The CLIF C-ACLF score of the study group was 53.78±7.75. The majority of the CWA waveform shape was normal (Sigmoid wave) at 42.5%, with biphasic waveform (BWP) at 27.5%, prolonged waveform at 22.5%, and combined waveform at 7.5%. The BWP waveform in patients with ALF and sepsis accounts for 78.6%, without sepsis 11.5%. The mean values of CWA: min1 3.02±1.38; min2 0.47±0.25; max2 0.43±0.27 were lower than the reference range. The values min1: 3.02±1.38, min2: 0.47±0.25, max2: 0.43±0.27 decreased according to the severity of ALF graded by ACLF (p<0.01), and the values min1, min2, max2 were negatively correlated with the CLIF C-ACLF score (r= -0.51; r= -0.36; r= -0.41) with p<0.05. Conclusions: All four types of CWA waveforms are observed in patients with acute liver failure. The CWA index values in patients with acute liver failure are lower compared to the reference range, and these values are related to the severity of the disease.