血栓弹力图评价冠心病合并高血压患者血栓风险的价值

Assessment value of thromboelastogram for thrombus risk in patients with coronary heart disease complicated hypertension

目的:观察血栓弹力图评价冠心病合并高血压病患者血栓风险的价值。方法:选择我院收治的120例冠心病(CHD)患者,按照是否有合并高血压分为单纯CHD组(58例)与CHD合并高血压组(62例),比较两组患者的血栓弹力图指标程度。结果:与单纯CHD组比较,CHD合并高血压组血凝块形成时间[K:(2.53±0.72)min比(1.82±0.64)min]、凝血反应时间[R:(8.66±1.86)min比(7.18±1.85)min]、花生四烯酸通道诱导的血小板活性[AA:(57.36±16.91)%比(46.73±20.73)%]明显减少,血块形成后最大振幅[MA:(57.31±7.75)mm比(64.36±7.85)mm]、从血凝块形成点至描记图最大曲线弧度作切线与水平线的夹角值[Angle:(53.26±7.78)°比(64.38±7.85)°]明显增加(P均<0.01)。Spearman相关分析显示,CHD合并高血压患者血压水平与Angle、MA成明显正相关(r=0.607、0.405,P均<0.01),与R、K成明显负相关(r=-0.256、-0.541,P均<0.01)。结论:对于冠心病合并高血压患者来说血栓形成具有更高风险,更容易引发急性心血管事件,因此应重视冠心病合并高血压患者凝血功能的监测,预防心脏不良事件的发生。

Objective： To observe assessment effects of thromboelastogram （TEG） on patients with coronary heart disease （CHD） complicated hypertension. Methods： A total of 120 CHD patients were selected from our hospital. According to complicated with hypertension or not, they were divided into pure CHD group （n = 58） and CHD ± hypertension group （n= 62）. TEG indexes were compared between two groups. Results： Compared with pure CHD group, there were significant reductions in blood clot formation duration EK.. （2.53 ± 0.72） min vs. （1.82 ± 0.64） min], coagulation reaction duration ER.. （8.66 ± 1.86） min vs. （7. 18 ± 1.85） mini, arachidonic acid pathway-in- duced platelet activity [-AA： （57.36 ± 16.91） % vs. （46. 73 ± 20. 73） %3, and significant rise in maximum amplitude after clot formation [-MA.. （57. 31 ± 7. 75） mm vs. （64.36 ± 7. 85） mm] and included angle value between the tangent from the blood clot forming point to the maximum curve radian of the chart and the horizontal line EAngle： （53.26 ± 7.78） vs. （64.38 ± 7.85） ] in CHD ± hypertension group, P-〈0.01 all. Spearman correlation analysis in- dicated that blood pressure level was significantly positive correlated with Angle and MA （r = 0. 607, 0. 405, P〈 0. 01 both）, and significantly inversely correlated with R and K （r = - 0. 256, - 0. 541, P〈0.01 both） in CHD ± hypertension patients. Conclusion.. Thrombosis possesses higher risk for CHD ± hypertension patients, which is eas- ier to cause acute cardiovascular events. Therefore, attention should be paid to coagulation function monitoring in order to prevent adverse cardiac events in these patients.