血栓弹力图在恶性肿瘤高凝状态诊断中的应用价值

Application value of thromboelastography in diagnosis of hypercoagulability of malignant tumor

目的探讨血栓弹力图(TEG)结合常规凝血参数、下肢深静脉血管超声多普勒等检查在诊断肿瘤患者是否存在高凝状态中的作用。方法 162例确诊为恶性肿瘤患者,同时行TEG、常规凝血参数及下肢深静脉血管超声检查,根据检查结果分为深静脉血栓形成组(A组)12例、红细胞聚集组(B组)23例及无血栓及红细胞聚集组(C组)127例。比较各组间反应时间(R值)、最大振幅(MA值)、α角、D-二聚体(D-Dimer)、纤维蛋白原(FIB)、纤维蛋白原降解产物(FDP)及血小板计数的关系。结果 A、B 2组间各项参数差异无统计学意义,而A、B组R值均显著低于C组,其余各参数均显著高于C组。结论 TEG结合常规凝血参数、下肢深静脉血管超声多普勒检查,可评估肿瘤患者凝血状态,预测深静脉血栓发生风险,可作为评判肿瘤患者是否需要抗凝治疗,降低血栓发生风险的手段之一。

Objective To investigate the effect of thromboelastography（TEG） in combination with routine haemostatic assays and ultrasonic doppler examination in deep veins of lower limbs in diagnosis of hypercoagulability of malignant tumor.Methods One hundred and sixty-two malignant tumor patients were examined by TEG,routine haemostatic assays and deep venous ultrasonic examination in lower limbs.According to the results,the patients were classified into deep venous thrombosis group（group A,n=12）,erythrocyte aggregation group（group B,n=23） and non-thrombus and erythrocyte aggregation group（group C,n=127）.The relationships between reaction time（R value）,maximum amplitude value（MA）,α angle,D-Dimer,fibrinogen（FIB）,fibrinogen degradation products（FDP） and platelet count of three groups were compared.Results There was no statistical significance in each parameter between groups A and B.The R values in groups A and B were significantly lower than that in group C,and the rest of the parameters were significantly higher than that in group C.Conclusion TEG combined with routine haemostatic assays and ultrasonic doppler examination in deep veins of lower limbs can assess the coagulant state in patients with tumor,predict occurred risk of deep venous thrombosis.It can be used to judge whether the patients need anticoagulation,and is one method of reducing the risk of thrombus.