血栓弹力图评估微炎症状态下腹膜透析患者凝血功能变化的价值

Evaluation on coagulative function in peritoneal dialysis patients with micro-inflammatory state by thromboelastograph

目的:利用血栓弹力图研究微炎症状态下持续性不卧床腹膜透析(CAPD)患者凝血功能的变化。方法:选择CAPD患者51例,根据C反应蛋白(CRP)水平分为CRP升高(>8 mg·L-1)组和CRP正常(≤8 mg·L-1)组,对比分析两组血栓弹力图和常规凝血指标的变化。结果:与CRP正常组相比,CRP升高组血栓弹力图反应时间(R)和凝血时间(K)显著缩短(均P<0.05),Angle(α角)、最大血块强度(MA)和综合凝血指数(CI)显著增加(均P<0.05)。常规凝血指标在两组间差异无统计学意义(P>0.05)。年龄和CRP与CI呈正相关(均P<0.05)。多元线性回归分析提示,CRP是CI的独立危险因素(P<0.05)。结论:与常规凝血指标相比,血栓弹力图是反映微炎症状态下CAPD患者高凝的一个更为灵敏的指标。

Objective： To investigate the changes of coagulative function in continuous ambulatory peritoneal dialysis（ CAPD） patients with micro-inflammatory state by thromboelastograph. Methods： Fifty-one CAPD patients were divided into two groups according to the level of C-reactive protein（ CRP）,the elevated（ 8 mg·L-1） and normal（ ≤ 8 mg · L-1） CRP group. The parameters of thromboelastograph and conventional coagulation were compared between the two groups. Results： Compared with the normal CRP group,reactive time（ R） and clot formation time（ K） were significantly shortened（ all P〈0. 05）,while alpha angle（ α）,maximum amplitude（ MA）and clot index（ CI） were significantly increased（ all P〈0. 05） in elevated CRP group. The parameters of conventional coagulation had no statistical significance（ P〈0. 05）. Age and CRP were positively correlated with CI（all P〈0. 05）. Multivariate linear regression showed that CRP was an independent risk factor of CI（ all P〈0. 05）. Conclusions： Compared to conventional coagulation examinations,thromboelastograph is a more sensitive method to reveal the existence of hypercoagulation status in CAPD patients with micro-inflammatory state.