缺血性脑卒中患者凝血相关指标变化规律的探讨

Study of the changing regulation of index related to coagulation of ischemic cerebrain stroke

目的研究急性缺血性脑卒中患者血栓弹力图检测指标、纤维蛋白原和血小板质和量的变化规律。方法选择90例急性缺血性脑卒中患者(实验组)和76例健康体检者(对照组),采集静脉血,用TEG5000血栓弹力图仪检测TEG参数(K值、Angle角、MA值);用Sysmex CA-7000全自动血凝仪检测血浆纤维蛋白原(Fib);用Sysmex xs-800i血细胞分析仪检测血小板的数量(PLT)和体积(MPV),对比2组上述指标的差异。结果急性缺血性脑卒中后MA值、Angle角、Fib和MPV明显高于对照组,差异有统计学意义(P<0.05),K值、PLT虽低于对照组,但差异无统计学意义(P>0.05)。结论急性缺血性脑卒中患者有Fib水平和PLT数量、形态的改变,血栓弹力图检测中的MA值、Angle角能比较敏感地反映脑血管疾病时凝血和血小板高凝的指标,可以作为对脑血管疾病具有实用价值的筛查试验。

Objective To research the changing regulation of detection index of thromboelastography（ TEG）,fibrinogen（ Fib）,the quantity and quality of platelet in patients with acute ischemic cerebral stroke. Methods 90 patients with acute ischemic cerebral stroke（ experimental group） and 76 healthy checkup persons（ contrast group） were enrolled in this study and venous blood samples were collected. TEG parameters including K,Angle and MA were detected by TEG5000. Fib was detected by Sysmex CA- 7000 automatic blood coagulometer. The quality（ MPV） and quantity（ PLT） of platelet were detected by Sysmex xs- 800 i hematology analyzer. And the differences of the above indexes of these two groups were discussed. Results The MA,Angle,Fib and MPV in patients with acute ischemic cerebral stroke were higher than the contrast group,and the differences were statistically significant（ P〈0. 05）. The value of K and PLT were lower than the contrast group,but the difference was not statistically significant（ P〈0. 05）. Conclusion Changes of Fib,PLT quality and quantity happen in the patients with acute ischemic cerebral stroke. MA and Angle in TEG can reflect the coagulation state of cerebrovascular diseases sensitively,and thus could be a valuable screening test for these patients.