血栓弹力图的数学模型

THE MATHEATICAL MODEL OF THROMBOELASTOGAM

根据以往的测量方法,血栓弹力图仅可提供三个唯象指标,r值(凝血反应时间),k值(纤维蛋白形成时间)。amax(血栓最大弹力度)。而缺乏其完整图形的理论分析模型。为此,本文测试描记了21例(16例正常人,5例患者)血样的血栓弹力变化曲线,并据其图形和理论推导,提出了凝血至部分纤溶全过程的弹力曲线数学方程,运用非线性拟合分析,证实了该方程式相当精确地表达了血栓弹力图的完整变化曲线。

ABSTRACT Hartert's thromboelastograph has been used in the diagnosis of abnormal conditions of blood clotting for more than 20 years. From a thromboelastogram, three parameters were obtained,viz,the reaction time V, the rate of formation of fibrin clot 'k', and the maximum elasticity of thrombus Nam3x/, It is desirable to know the equation for describing a thromboelastogram from the increase to the decrease of the complex modulus during fibrinplysis. Experiments have been done in 16 normal controls and 5 patients by recacification methods. Analyzing the thromboelastograms and the chemical dynamic process of blood clotting,we found that the complex modulus of th romboelastogram is composed of two parts, one being the increase of complex modulus during coagulation expressed by G, = G,'EXP( -T,/t), and the other, decteasa of complex modulus during flbrinolysis expressed by G2=G/EXP( -T,/( t-D) ), when t>D, then the new regression equation being G = -G,'H( t )EXP( -Ti/t )-G/H(t-D)EXP( -T,/( t-D) ) Where H(t) and H ( t-D ) is step functions,i.e., H ( t ) or H ( t-D ) = O, when t or ( t-D ) <0j and H ( t ) or H ( t-D ) = 1, when t or(t-D)>0. Our equation fits the thromboslastogrems very well and includes five constants GI', G2', TI, T2, and D to be quantified by non-linear regression analysis. It would ba prospective to use the five constants for diagnostic and prognostic purpos3 of abnormal conditions of blood coagulation and fibrinolysis.