心肌梗死合并糖尿病患者血栓弹力图变化探讨

Study on the change of TEG about myocardial infarction combined with diabetes

目的对比心肌梗死合并糖尿病患者血栓弹力图指标和血小板相关指标的差异,并探讨血栓弹力图(TEG)相关指标与血小板相关指标的相关性。方法收集2016年1~12月上海第九人民医院与上海中冶医院114例患者临床资料,分为心肌梗死合并糖尿病组(54例)、糖尿病组(20例)和对照组(40例)。采用单因素方差分析比较各组间的TEG各项指标及血小板相关指标的差异,应用Pearson相关性分析心肌梗死合并糖尿病患者TEG指标及血小板参数之间的相关性。结果心肌梗死合并糖尿病组凝血形成速率α角(α-Angle)、凝血块最大强度(MA)、凝血综合指数(CI)、平均血小板体积、大血小板比率、血小板体积分布宽度均高于对照组,凝血反应时间(R)、凝血形成时间(K)低于对照组(P<0.05)。心肌梗死合并糖尿病患者R值与平均血小板体积呈正相关,α-Angle与平均血小板体积、大血小板比率比率、血小板体积分布宽度呈正相关,MA与血小板比容呈正相关(P<0.05)。结论TEG参数对于心肌梗死合并糖尿病的诊断具有一定参考价值,与血小板相关指标具有较好相关性。

Objective To analysis the difference between the indexes of thrombus mapping and platelet related factors in patients with myocardial infarction and diabetes mellitus, and to explore the correlation between the relevant indexes of TEG and the related parameters of platelet. Methods From January to December in 2016, clinical data of 114 patients in Shanghai Ninth People′s Hospital and Shanghai MCC Hospital were collected. They were divided into myocardial infarction combined with diabetes mellitus group（54 cases）, diabetes mellitus group（20 cases） and control group（40 cases）.The differences between TEG indicators and platelet related indicators in each group were analyzed by One-Way ANOVA. The correlation between TEG index and platelet parameters in patients with myocardial infarction combined with diabetes mellitus was analyzed by Pearson correlation. Results The α-Angle, the value of MA, CI, mean platelet volume, platelet large cell ratio and platelet volume distribution width in the myocardial infarction combined with diabetes mellitus group were higher than those in the control group（P〈0.05）. Besides, the value of R and K in the myocardial infarction combined with diabetes mellitus group were lower than those in the control group（P〈0.05）. The R value of myocardial infarction combined with diabetes was positively correlated with the platelet volume distribution width,and the α-angle was positively correlated with mean platelet volume, platelet large cell ratio and platelet volume distribution width, and MA was positively correlated with thrombocytocrit（P〈0.05）. Conclusion TEG parameters have a certain reference value for the diagnosis of myocardial infarction combined with diabetes mellitus, and have a good correlation with platelet related indexes.