血栓弹力图评价老年脑梗死患者高凝状态的意义

Evaluation of Hypercoagulable State by Thromboelastography in Elderly Patients with Cerebral Infarction

目的评价血栓弹力图在老年脑梗死患者凝血状态监测中的临床意义。方法选取300例老年脑梗死患者作为观察组，300例同期老年体检者作为对照组，对所有患者进行常规凝血检测和血栓弹力图检测。结果两组常规凝血指标之间比较差异无统计学意义（P〉0．05）。与对照组相比，观察组反应时间（R值）和凝血酶形成时间（K值）均明显缩短（P〈0．05）；观察组血栓最大弹力度（MA值）、凝血指数（CI值）和凝固角（Angle角）均明显增大（P〈0．05，P〈0．01）。观察组中有164例患者处于高凝状态，其中包括28例患者为凝血因子活性增高，70例患者为血小板活性升高，44例患者为纤维蛋白原活性升高，22例患者出现纤维蛋白原和血小板活性同时升高。结论血栓弹力图能全面地反映老年脑梗死患者的高凝状态及其原因，对老年脑梗死患者的个体化治疗有重要的临床意义。

Objective To evaluate the significance of thrombelastograph in elderly patients with cerebral infarction. Methods 300 patients with acute cerebral infarction were enrolled into the observation group, 300 elderly people underwent physical examinations as the control group. Routine coagulation testing and thromboelastography were performed in all cases. Results There was no significant difference between the two groups in the value of conventional coagulation （ P 〉 0.05 ）. The reaction time （R） and prothrombin formation time （K） in the observation group were significantly shorten than those in the control group （ P 〈0. 05 ）. The maximum amplitude （MA）, the coagulation index （CI） and the solidification angle （Angle） in the observation group were greater than those in the control group （P 〈 0. 05, P 〈 0. 01 ）. 164 cases in the observation group presented in a hypercoagnlable state. Clotting factor activity was high in 28 cases. Platelet activity increased in 70 cases. Fibrinogen activity increased in 44 cases. Platelet and fibrinogen activity were high in 22 cases. Conclusion Thrombelastogram can not only reflect hypercoagulable state in patients with acute cerebral infarction, but also may indicate the cause of hypercoagnlability.