血栓弹力图在心血管疾病诊治中的应用进展

Clinical Use in Cardiovascular Disease of Thrombelastogram

血栓弹力图是应用血栓弹力图仪动态检测凝血、血小板聚集、纤维蛋白溶解过程中凝血块的黏弹性变化所绘制的一条时间与血栓弹力的变化曲线,常规凝血检测大多数仅能检测凝血过程中的一个阶段、一个片段,而血栓弹力图可动态检测凝血全貌,这决定了血栓弹力图可作为检测血液凝固状态(高凝、低凝)和纤维蛋白溶解现象的一种辅助诊断手段。近年来该技术广泛应用于指导术中输血、高凝状态的监测及纠正、创伤病人的救治及凝血机制的研究。在心血管疾病患者的凝血监测、评估抗血小板药物(阿司匹林、氯比格雷等)疗效及抵抗进展等方面越来越多地应用,现就血栓弹力图的设计原理、参数解读及在心血管疾病中的应用做一综述。

Thrombelastogram is an image reflecting the viscoelasticity changes of blood clots in the process of blood clotting,platelet aggregation and fibrinolysis. Routine coagulation tests mostly can only be a phase detection of coagulation process,however thrombelastogram can be dynamic detection of coagulation profile,which determines the thrombelastogram can be as an auxiliary diagnosis means to detect the blood coagulation state and fibrin dissolution phenomena. In recent years,the technology is widely used in guiding intraoperative blood transfusion,hypercoagulable state monitoring and correcting,trauma treatment and coagulation mechanisms. Thrombelastogram is widely used in the area of cardiovascular disease. We discuss the clinical applications in cardiovascular disease of thrombelastogram in this article.