自动校正凝血酶曲线法监测脑出血患者凝血功能的初步研究

Application of calibrated automated thrombography in monitoring coagulation function in cerebral hemorrhage patients

目的采用自动校正凝血酶曲线法监测患者脑出血后机体凝血功能的变化状态。方法收集经头颅CT确诊、发病18h内入院的自发性脑出血患者20例作为脑出血组,选择年龄、性别匹配的健康体检者29例作为对照组。对照组体检时、脑出血组于入院6h内采用流行病学调查方式进行调查,同时进行实验室检查;脑出血组于入院第4、8和15天或出院时,再次采用自动校正凝血酶曲线法检测机体凝血功能。结果脑出血组患者入院时、入院第4和8天的延迟时间高于对照组[(9.17±8.90)min、(7.72±5.55)min、(6.56±4.44)min vs(3.26±0.77)min,P=0.002];入院时、入院第4、8和15天或出院时凝血酶生成潜力、峰值低于对照组,达峰时间长于对照组(P<0.05)。结论脑出血患者在初期呈低凝状态,凝血功能于第15天或出院时基本恢复,但仍低于健康人群。

Objective To study the application of calibrated automated thrombography in monitoring coagulation function in cerebral hemorrhage （CH） patients.Methods Twenty spontaneious CH patients admitted to our hospital within 18 h after onset of their disease served as a CH group and 29 age-and gender-matched subjects undergoing physical examination served as a control group in this study.Patients in CH group underwent laboratory tests within 6 h after admission and their coagulation function was tested on days 4,8 and 15 after admission or at the time when they were discharged by calibrated automated thrombography.Results The delayed time of coagulation was longer （P=0.002） while the ETP and its peak value were lower and the time to reach its peak value was longer in CH group than in control group at admission and on days 4 and 8 after admission.Conclusion The early coagulation function is low in CH patients and returns to its normal level on day 15 after admission or at the time when they are discarged.However,it is still lower than that in healthy populations.