两种不同凝血功能检测方法的相关性和一致性研究

Correlation and Consistency of Two Different Methods for Detecting Coagulation Function

目的:研究2种不同凝血功能检测方法的相关性和一致性。方法:对本院106例重症监护室与消化内科住院患者进行回顾性分析。收集患者血栓弹力图实验与凝血4项等临床资料,对2者结果进行统计学分析。结果:血栓弹力图实验的K值、MA值、α-Angle均与纤维蛋白原存在显著相关性(r=-0.62、0.36、0.38,均P<0.01),R时间与凝血酶原时间、活化部分凝血活酶时间均存在显著相关性(r=0.31、0.35,均P<0.01);K值、MA值、α-Angle与纤维蛋白原的Kappa值也存在显著相关性(r=0.34、0.46、0.31,均P<0.05),卡方检验值分别是1.12、1.42、0.14(P=0.28、0.21、0.69);血栓弹力图实验的R时间与凝血酶原时间、活化部分凝血活酶时间的Kappa值分别是为0.05、0.07(P=0.88、0.81),卡方检验值分别是19.57、9.07(均P<0.01)。结论:血栓弹力图实验与凝血4项呈现显著相关性,但二者一致性较差,两种方法无法相互替代,尚不能评估何种检测手段更能判断患者的出血风险。

Objective： To study the correlation and consistency of the 2 different methods for detecting coagulation function. Methods： One hundred and six inpatients of ICU and department of gastroenterology in our hospital were retrospectively analyzed. The clinical data of thromboelastography and coagulation test were collected,and the detection results of 2 different methods were statistically analyzed. Results： The K,MA value and α-Angle in thrombelastometry significantly related with fibrinogen（ r =-0. 62,0. 36,0. 38,all P〈0. 01）,and the R time significantly related with prothrombin time and activated partial thromboplastin time（ r = 0. 31,0. 35,both P〈0. 01）; the Kappa values of K value,MA value,α-Angle and fibrinogen value were 0. 34,0. 46,0. 31 respectively（ all P〈0. 05）,and the chi square test values were respectively 1. 12,1. 42,0. 14（ P = 0. 28,0. 21,0. 69）; the Kappa values of R time in thrombelastometry with prothrombin time,activated partial thromboplastin time（ APTT） were respectively 0. 05,0. 07（ P = 0. 88,0. 81）,and the chi square tests showed that the Kappa values were respectively 19. 57,9. 07（ both P〈0. 01）. Conclusion： Thromboelastography and coagulation test show significant correlation,with poor consistency,so the 2 kinds of methods can not be replaced for each other,which still can not be used to better assess the risk of bleeding.