[Application value of thromboelastography in assessing coagulation function in children with severe hemophilia A after emicizumab therapy: a single-center study].

Q3 Medicine

中国当代儿科杂志 Pub Date : 2025-03-15 DOI:10.7499/j.issn.1008-8830.2409099

Dong Peng, Ying Wang, Gui-Chi Zhou, Qian Li, Mei-Zhu Luo, Li-Ping Luo, Ya-Xian Kuang, Xiao-Ying Fu

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引用次数: 0

Abstract

Objectives: To investigate the application value of thromboelastography (TEG) in assessing coagulation function in children with severe hemophilia A (HA) after emicizumab (EMI) therapy.

Methods: A retrospective analysis was performed on the activated partial thromboplastin time (APTT) and TEG testing results of 17 children with severe HA before and after EMI treatment at Shenzhen Children's Hospital from January 2023 to July 2024. Correlation analysis was conducted between coagulation factor VIII (FVIII) equivalent activity and reaction time (R value) measured by TEG.

Results: After EMI treatment, the mean bleeding rate for children with severe HA was 1.6 events per year, with 15 children (88%) without spontaneous bleeding or joint bleeding. The children with severe HA showed a significant reduction in APTT after EMI treatment (P<0.05), with a significantly shorter APTT than the normal control group (P<0.05). There was no correlation between APTT and FVIII equivalent activity after treatment (P>0.05). After EMI treatment, TEG parameters, including R value, kinetic time, alpha angle (α), maximum amplitude, clot strength, and coagulation index, shifted from a hypocoagulable state before treatment to a nearly normal state after treatment (P<0.05). The R value demonstrated a strong negative correlation with FVIII equivalent activity (r=-0.758, P<0.05).

Conclusions: The bleeding condition of children with severe HA can be effectively controlled after EMI treatment. Routine APTT testing cannot reflect true coagulation function, whereas TEG testing is clinically valuable in assessing the coagulation function of children with severe HA undergoing EMI treatment.

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[血栓弹性成像在评估半珠单抗治疗后严重A型血友病患儿凝血功能中的应用价值：一项单中心研究]。

目的：探讨血栓弹性成像（TEG）在评估半珠单抗（EMI）治疗后严重血友病A （HA）患儿凝血功能中的应用价值。方法：回顾性分析深圳儿童医院2023年1月至2024年7月收治的17例重度HA患儿EMI治疗前后的活化部分凝血活素时间（APTT）和TEG检测结果。凝血因子VIII （FVIII）等效活性与TEG测定的反应时间（R值）进行相关性分析。结果：经EMI治疗后，严重HA患儿的平均出血率为每年1.6次，其中15例患儿（88%）无自发性出血或关节出血。重度HA患儿经EMI治疗后APTT明显降低（PPP 0.05）。经EMI治疗后，TEG参数R值、动力学时间、α角（α）、最大振幅、凝块强度、凝血指数等由治疗前的低凝状态转变为治疗后的接近正常状态（Pr=-0.758, p）。结论：经EMI治疗后，重症HA患儿出血情况可得到有效控制。常规APTT检测不能反映真实的凝血功能，而TEG检测在评估接受EMI治疗的严重HA患儿凝血功能方面具有临床价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

中国当代儿科杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

1.50

自引率

0.00%

发文量

5006

期刊介绍： The Chinese Journal of Contemporary Pediatrics (CJCP) is a peer-reviewed open access periodical in the field of pediatrics that is sponsored by the Central South University/Xiangya Hospital of Central South University and under the auspices of the Ministry of Education of China. It is cited as a source in the scientific and technological papers of Chinese journals, the Chinese Science Citation Database (CSCD), and is one of the core Chinese periodicals in the Peking University Library. CJCP has been indexed by MEDLINE/PubMed/PMC of the American National Library, American Chemical Abstracts (CA), Holland Medical Abstracts (EM), Western Pacific Region Index Medicus (WPRIM), Scopus and EBSCO. It is a monthly periodical published on the 15th of every month, and is distributed both at home and overseas. The Chinese series publication number is CN 43-1301/R；ISSN 1008-8830. The tenet of CJCP is to “reflect the latest advances and be open to the world”. The periodical reports the most recent advances in the contemporary pediatric field. The majority of the readership is pediatric doctors and researchers.