急性脑梗死患者血栓弹力图与凝血功能检查的相关性研究

Relationship between thromboelastogram and coagulation function test in patients with acute cerebral infarction

目的分析急性脑梗死患者血栓弹力图与凝血功能检查的相关性。方法选取急性脑梗死患者106例,根据神经功能缺损程度评分分为轻度组44例,中度组38例,重度组24例,同期入组50例健康体检者作为对照组。检测血栓弹力图(TEG)参数[凝血反应时间(R)、血细胞凝集块形成时间(K)、血细胞凝集块形成速率(a角)、血凝块最大强度或硬度(MA)、凝血综合指数(Cl)]和凝血四项[血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、血浆纤维蛋白原(FIB)、D-二聚体(DD)],进行TEG参数与凝血功能指标的Person相关性分析等。结果急性脑梗死组TEG参数中R值和K值明显低于对照组,差异有统计学意义;a角、MA、DD、FIB值明显高于对照组。轻度组、中度组、重度组TEG参数中R值、K值、a角、MA、DD、FIB值差异有统计学意义(P<0.05);R值、K值与PT、APTT呈正相关性(P<0.05),与DD、FIB呈负相关性(P<0.05);a角、MA值、Cl与PT、APTT呈负相关,与DD、FIB呈正相关(P<0.05)。结论急性脑梗死患者存在凝血功能异常,血栓弹力图各项参数与凝血功能具有明显相关性;血栓弹力图与凝血功能检查有利于疾病诊断及病情评估,TEG的动态监测具有检测简便、快速、敏感、重复性好的特点。

Objective To analyze the correlation between thromboelastogram and coagulation function test in patients with acute cerebral infarction. Methods A total of 106 patients with acute cerebral infarction were selected. In patients with acute cerebral infarction,neurological impairment scores were divided into mild group of 44 patients,moderate group of 38 patients,and severe in 24 cases,50 healthy volunteers were enrolled in the same period as a control group. All to test the thromboelastogram（ TEG） parameters[blood clotting reaction time（ R） ],haemagglutinating block formation time（ K）,haemagglutination clot formation rate（ a angle）,blood clot maximum strength or hardness（ MA）,coagulation composite index（ Cl）,and coagulation four [plasma prothrombin time（ PT） ],partial thromboplastin time（ APTT）,plasma fibrinogen（ FIB）,The D-dimer（ DD） test results were used to analyze the correlation between the TEG parameters and the blood coagulation function index. Results The R value and K value of the TEG parameters in the acute cerebral infarction group were significantly lower than those in the control group. The difference was significant. The values of a angle,MA,DD and FIB were significantly higher than those of the control group. In the mild,moderate,and severe groups,the R value,K value,a angle,MA,DD,and FIB values were significantly different in the TEG parameters. R value and K value were positively correlated with PT and APTT,negatively correlated with DD and FIB,a negative correlation was found between a angle,MA value,Cl and PT,APTT,and positive correlation with DD and FIB. Conclusion There are abnormal coagulation function in patients with acute cerebral infarction. The parameters of thromboelastography are related to coagulation function. Thromboelastogram and coagulation function test are conducive to disease diagnosis and condition assessment. The dynamic monitoring of TEG is simple,rapid and sensitive.,repeatability characteristics.