血栓弹力图在高凝状态检测中的应用

THE USE OF THROMBOELASTOGRAPHY IN DETECTION OF HYPERCOAGULABLE STATE

对３６例高凝状态患者进行了血栓弹力图（ＴＥＧ）和抗凝血加生理盐水（９：１）稀释的ＴＥＧ检测，并以１８名正常人为对照。结果表明患者组ＴＥＧ的凝血指数（ＣＩ）和血栓最大弹力度（ｍａ）均明显高于对照组（Ｐ值分别＜０．００１和０．０５）．生理盐水稀释后６９．４％的患者ＣＩ增高了，ｍａ也明显增大，致使两组间差异更趋显著（Ｐ＜０．００１）。证实血液经生理盐水一定比例稀释后可提高ＴＥＧ反映高凝状态的敏感性。作者认为ＣＩ超过５０°，ｍａ超过６０ｍｍ为血液凝固性增高的表现。血液经９：１生理盐水稀释后ＣＩ增加超过原来２０％者更有意义。

Thromboelastograpby(TEG) accurately records the kinetic process of clot formation during blood coagulation.Various indices including reaction time(r),coagulation time(K),and maximal strength and firmness(ma)are described and expressed in the tracing.It is also found that the coagulation index(CI) is useful in the assessment of a hypercoagulable state.In this study,the authors used TEG to study the hypercoagulable state in various thrombotic diseases,and compared the indices of this group with normal individuals.It was shown that the ma and CI were significantly increased in the thrombotic group,while the value of r was not much different in the two groups.Previous dilution of the blood sample with normal saline at a ratio of 9:1,saved an even more conspicuous difference.The values determined in thrombotic diseases increased to a greater extent, which was presumably ascribed to increased activation of the coagulation process in thrombotic diseases.From the study,the authors conclude that TEG might serve as a useful tool in studies of hypercoagulable states.