TEG血栓弹力图同常规凝血试验的关系及TEG血小板图试验的临床应用

The relationship beteen TEG thromboelastography test and routine haemostatic assays,and clinical application of TEG Platelet Mapping assay

目的探讨TEG血栓弹力图试验同常规凝血试验的关系,并回顾分析TEG血小板图试验监测抗PLTs药物的临床效果。方法①100例患者,每位分别同时抽取静脉血,做TEG血栓弹力图、常规凝血(aPTT、PT、TT、Fbg)和血常规检测。采用线性相关与回归、多元线性回归与偏回归,评估各参数间关系。②对TEG血小板图试验监测抗PLTs药物的疗效进行回顾性分析。③着重分析MA与PLTs数量的关系。结果 ①MA和CI值均分别与Fbg、PLTs和aPTT,R与aPTT、PT和TT,A与PLTs、aPTT,K值与PLTs均分别显著相关(P=0.034-0.000)。R、A、K、MA任意两参数间显著相关(P=0.029-0.000)。A与K符合对数关系(P=0.000)。多元回归显示,各TEG参数分别受2个或多个常规凝血参数的影响,TEG参数间也相互影响。②TEG血小板图监测阿司匹林和波利维的显效率分别达到82.9%和71.4%。③MA虽同PLTs高度相关,但相近的MA值对应的PLTs数目却相当广泛。结论部分TEG参数与常规凝血参数、以及TEG参数间相关性显著。MA比PLTs计数更能准确的反映PLTs对凝血系统的影响。TEG血小板图试验在评估抗PLTs药物疗效上的应用前景值得进一步探讨。

Objective To investigate the relationship between TEG thromboelastography（TEG）and routine haemostatic assays,and review the effect of anti-platelet drugs such as aspirin and Clopidogrel by TEG PlateletMapping assay. Methods （1）For 100 patients,venous blood samples of each patient were withdrawn simultaneously,and TEG, rou- tine haemostatic assays such as aPTT, PT, TT, Fbg and platlets（PLTs）were determined. Linear correlation and regression,multiple linear regression and partial regression were carried out to analyze relationship among the parameters. （2） The anti-platelet effect of aspirin and clopidogrel determined by TEG plateletmapping assay was reviewed. （3）Relationship of MA and PLTs were analyzed specially. Results （1）Significant correlativity were observed between either MA or CI and Fbg,PLTs or aPTT,the same result were obtain beteen R and aPTT,PT and TT,Angle and PLTs or aPTT,K K and PLTs （P=0. 034-0. 000） ,either two of R,A,K and MA（P=0. 029-0. 000） except A and K（logarithm correlativity, P= 0. 000）. By multiple regression,each TEG parameter was influenced by two or more parameters Of routine assay,and TEG parameters interacted also. （2）By TEG PlateletMapping assay,82.9% of those taken aspirin and 71.4% taken clopidogrel were identified a definitive effect, （3）Although MA correlate with PLTs significantly,the similar,MA values correspond with a diverse numbers of PLTs. Conclusion There were significant correlation between some of the TEG paraeters and those of routine haemostatic assays, or between TEG parameters. ,MA can better reflect platelets function in haemostatic system. Further investigation of TEG plateletmapping assay should be carried out.