• J Sun, Y Tian, R C Jiang, X L Dong, Y Wang, W B Wu, K X Wu, and J N Zhang.
• Department of Neurosurgery, Tianjin Medical University General Hospital & Tianjin Neurological Institute; Key Laboratory of Post-trauma Neuro-repair & Regeneration in Central Nervous System, Ministry of Education; Tianjin Key Laboratory of Injuries, Variations & Regeneration of Nervous System, Tianjin 300052, China.
• Zhonghua Yi Xue Za Zhi. 2016 Oct 25; 96 (39): 3125-3128.

AbstractObjective: In this study, we tested platelet count (PC), prothrombin time (PT), activated partial thromboplastin time (APTT), and other indicators of coagulation function, and revealed their difference in patients with traumatic brain injury (TBI) between plain and plateau area. Base on the results, we may provide research basis for the therapy of TBI associated coagulopathy in different areas. Methods: 151 TBI patients from Tianjin Medical University General Hospital, and 74 from People's Hospital of Tibet Autonomous Region in the period from Dec 2013 to Dec 2015 were enrolled.Coagulation function, including PC, platelet distribution width (PDW), mean platelet volume (MPV), platelet - large cell ratio (P- LCR), PT, APTT, fibrinogen (FIB), and D- Dimer were tested within 8 h. The difference in patients with TBI between plain and plateau areas were compared and analyzed. Results: Compared with plain area, the PC of patients with TBI in plateau area is lower [(168±49)×109/L vs (196±72)×109/L, P<0.05], while PT and APTT were extended [(13.5±1.3) s vs (12.0±4.0) s, (38±4) s vs(27±6) s, P<0.01]. On the other hand, FIB increases [(3.1±1.2) g/L vs (2.6±1.0) g/L, P<0.01] and D-Dimer decreases [(3.1±3.3) μg/L vs (4.7±3.6) μg/L, P<0.01] in plateau area compared with plain area. Conclusion: Due to the people of plateau area living in hypoxia state, the coagulation function is activated for a long time.Once TBI happens, the platelets and coagulation factors may be excessive consumption, resulting in hypocoagulable state and high risk of rebleeding, while the fibrinolysis system in patients with TBI of plateau area is not activated obviously.Therefore, it should give full consideration to these differences in the treatment of patients with TBI in plateau area, instead of directly copying the standard therapy of the people in plain area.The treatment recommendations should primarily supplement coagulation materials, and antifibrinolytics may unlikely have the therapy effect.

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