无症状脑梗死患者治疗前后TEG与常规凝血功能的相关性分析

Correlation analysis of TEG and routine coagulation function before and after treatment in patients with silent cerebral infarction

目的:探讨血栓弹力图(TEG)检测无症状性脑梗死急性期患者治疗前后凝血功能及其与常规凝血功能指标的相关性。方法:选取2015-08-2016-09收治的90例老年无症状性脑梗死急性期患者,所有患者住院当天即进行TEG检测和常规凝血功能检测,在患者经过4周的治疗后再次进行TEG和常规凝血功能检测,比较前后2次检测的结果。结果:治疗后患者的R时间、K时间和APTT、PT-INR、PT等指标均显著高于治疗前,而FIB、CI、MA、α角等指标则显著低于治疗前(均P<0.05)。在90例入选患者中,TEG检测出62例高凝状态患者,灵敏度为68.89%,而常规凝血功能检测出的高凝状态患者为36例,灵敏度为40.00%,即治疗前常规凝血功能检测对高凝状态的检出率显著低于TEG检测(χ2=13.382,P<0.01)。在90例入选患者中,TEG检测出46例高凝状态患者,灵敏度为51.11%,而常规凝血功能检测出的高凝状态患者为27例,灵敏度为30.00%,即治疗后常规凝血功能检测对高凝状态的检出率显著低于TEG检测(χ2=7.345,P<0.01)。患者的R值和PT-INR值以及PT值呈正相关关系,与FIB值则为负相关关系(均P<0.01);CI值和PT-INR值以及PT值均呈负相关关系(均P<0.01),和FIB值则为正相关关系(P<0.05);FIB值和MA值为正相关关系(P<0.05);其他检测指标之间并无明显的相关性。结论:TEG检测能够从多方面对无症状性脑梗死患者的凝血系统进行较为全面的评估,其灵敏度显著优于常规的凝血功能检测,在临床诊治无症状性脑梗死患者上具有较高的指导意义。

Objective：To investigate the TEG detection of coagulation function before and after treatment in patients with symptoms of acute cerebral infarction and normal coagulation index correlation.Method：Select our hospital from August 2015 to September 2016 admitted during the period of 90 cases of elderly patients with asymptomatic cerebral infarction in acute stage,all of the patients in hospital on the same day that detect thrombi elastic graph（Thrombelastogram,TEG）and conventional coagulation function testing,again in patients after 4 weeks of treatment with TEG and conventional coagulation function testing,the testing results of the comparison before and after two.Result：R display time of patients after treatment,K time and APTT,PT-INR,PT and other indicators were significantly higher than that before treatment,FIB,CI,MA,alpha angle is significantly lower than the index before treatment（P〈0.05）.According to these two detection methods showed that after treatment in patients with hypercoagulable state are effective improvement.In 90 patients,TEG detected 62 cases of patients with hypercoagulability,sensitivity 68.89%,while the hypercoagulable state in patients with detection of coagulation function in 36 cases,the sensitivity was 40%,the detection rate of treatment before the routine coagulation function test on hypercoagulable state was significantly lower than the detection of TEG（χ2=13.382,P〈0.01）.In 90 patients,TEG detected 46 cases of hypercoagulable state in patients with a sensitivity of 51.11%,while the conventional blood coagulation function detection The hypercoagulable state in patients with 27 cases,the sensitivity was 30%,the routine coagulation function after treatment of hypercoagulable state detection detection rate was significantly lower than the detection of TEG（χ2=7.345,P〈0.01）.Patients with R and PT-INR values and PT values were positively correlated,and FIB value was negative correlation（both P〈0.01）;the CI value and PTINR value and PT value were negatively correlated（P〈0.01）,and the FIB value was a positive correlation（P〈0.05）;the FIB and MA values were positive correlation（P〈0.05）;other detection means There was no significant correlation between the markers.Conclusion：TEG detection of a more comprehensive assessment of the blood coagulation system of patients with asymptomatic cerebral infarction from various angles,its sensitivity is significantly better than the conventional detection of coagulation function,no higher in patients with symptomatic cerebral infarction on significance in clinical diagnosis and treatment.