比较血栓弹力图与常规凝血检验在慢性肾脏病中的应用研究

Study on the Comparison of Thromboelastogram and Routine Coagulation Test in Chronic Kidney Disease

目的:分析血栓弹力图(TEG)与常规凝血检验在慢性肾脏病(CKD)中的应用。方法:选择某院40例CKD患者,根据病情不同将其分为5组,分别为A组(CKD1～2期)、B组(CKD3期)、C组(CKD4期)、D组(CKD5期未透析)与E组(CKD5期透析),各8例,均实施TEG与常规凝血检验对其进行检查,对比检验结果。结果:(1)5组患者TT、APTT、PT、INR、Fib、D-Dimer比较无差异(P>0.05);C组及E组Fib值高于A组(P<0.05);D组、E组D-Dimer值比A组高(P<0.05);E组D-Dimer值比D组低(P<0.05)。(2)D组、E组R、K、Angl、MA、CI值与A组比较差异显著(P<0.05);C组K、MA值与A组比较差异显著(P<0.05);C组MA值比A组、B组高(P<0.05);E组K值比B组低(P<0.05);E组Angl值比D组、B组高(P<0.05)。结论:血栓弹力图联合常规凝血检验对慢性肾脏病进行检测,可有效的评估患者的凝血状态,为治疗提供科学依据。

Objective To compare the application of TEG and conventional coagulation test in CKD. Methods： 40 patients with CKD in a hospital were divided into five groups： group A （CKD stage 1～2）, group B （CKD stage 3）, group C （CKD stage 4）, group D （CKD stage 5 without dialysis） and group E （CKD stage 5,dialysed）, 8 cases in each group, TEG and routine coagulation tests were performed and the test results were compared. Results： There were no differences in TT, APTT, PT, INR, Fib, and D-Dimer between the five groups （ P 〉0.05）. The Fib values in group C and group E were higher than those in group A （ P 〈0.05）. Groups D and E The D-Dimer value was higher than that of the A group （ P 〈0.05）; The D-Dimer value of the E group was lower than that of the D group （ P 〈0.05）. The values of R, K, Angl, MA and CI in group D and group E were significantly different from those in group A （ P 〈0.05）. The values of K and MA in group C were significantly different from those in group A （ P 〈0.05）. The values of MA in group C were higher than group A and group B （ P 〈0.05）; The values of K in group E was lower than the B group （ P 〈0.05）; The Angl value in group E was higher than group D and group B（ P 〈0.05）. Conclusion： The thromboelastography combined with conventional coagulation test for chronic kidney disease can effectively evaluate the patient＇s coagulation status and provide a scientific basis for treatment.