探讨血栓弹力图和常规凝血功能检测在急性胰腺炎患者中的应用价值

To explore the clinical value of thrombelastogram and routine coagulation function tests in the patients with acute pancreatitis

目的:探讨血栓弹力图和常规凝血功能检测用于评估急性胰腺炎患者凝血功能状态的临床应用价值。方法:选取126例被确诊为急性胰腺炎的患者,其中病情轻度组96例、重度组30例。入院后分别进行血栓弹力图、凝血4项和血常规检测;将血栓弹力图参数与凝血4项及血小板进行相关性分析,并将结果与正常对照进行比较分析。结果:K值和α角分别与TT、PLT存在相关性(P<0.01);MA值和G值分别与FIB、PLT存在相关性(P<0.01)。急性胰腺炎患者组R值、Angle角、MA值、G值、PT、FIB、APTT明显高于正常对照组(P<0.05);其中重度急性胰腺炎患者组MA值、G值、PT值明显高于轻度组(P<0.05),与疾病严重程度相关。结论:临床上可采用血栓弹力图和常规凝血功能检查联合检测用来评估急性胰腺炎患者的凝血功能状态,对疾病的诊断、严重程度的判断及治疗有着一定的临床意义。

Objective.. To discuss the clinical value of thrombelastogram（TEG） and routine coagulation function tests in assessing the state of coagulation in the patients with acute pancreatitis. Method： A total of 126 cases of acute panereatitis patients were selectedincluding 106 cases of mild acute pancreatitis as MAP group and 30 cases of severe acute pancreatitis as SAP group. Those patients were tested for TEG, four routine coagulation tests and bloodroutine test after admission. The TEG, routine coagulation tests and platelet counts of 126 patients were analyzed for theircorrelation analysis. The results of thrombelastogram and four routine coagulation tests were compared between acute pancreatitis patients and normal control. Result：The value of K and Angle were positively cor- related with TT and PLT, respectively （P〈0.01）. Significant correlated were observed between MA or G and FIB, PLT （P〈0.01）. The levels of R, Angle, MA, G, PT, FIB and APTT of the patients with acute pancreatitis were significantly higher than those in thecontrol group（P〈0.05）. While the levels of MA, G and PT in SAP were significantly higher than those in NAP. Conclusion.. Clinically, the combination of TEG and routine coagula- tion function tests can be used to assess the status of coagulation function in patients with acute pancreatitis. It may have a certain clinical effect on diagnosis and treatment of disease.