不典型膜性肾病患者血栓弹力图与常规凝血试验相关性分析

The correlation analysis the thrombelastogram and conventional coagulation tests in patients with atypical membranous nephropathy

目的:探讨血栓弹力图(TEG)各指标与常规凝血试验各指标间的相关性,评价两种方法在检测不典型膜性肾病(AMN)患者高凝状态中的价值。方法:选择肾病患者120例,其中不典型膜性肾病组60例,慢性肾炎组60例,所有患者均行常规凝血试验和TEG检测,分析其相关性。结果:不典型膜性肾病组与慢性肾炎组R值分别为(5.41±0.65)min、(6.40±1.56)min,K值分别为(1.11±0.37)min、(2.16±0.58)min,a角分别为(71.08±5.93)°、(59.88±5.47)°,MA值分别为(71.51±5.58)mm、(60.13±5.02)mm,CI值分别为(2.23±1.98)、(-0.99±1.14),两组各项比较差异均有统计学意义(P<0.05);两组LY30为(0.99±0.37)%和(0.91±0.29)%,相比较差异无统计学意义(P>0.05);两组常规凝血试验指标比较,差异无统计学意义(P>0.05);TEG检测的多项参数与常规凝血试验指标存在相关性,R值与PT、INR正相关,与FIB负相关;K值与PT、INR、TT正相关,与FIB负相关;a角、MA与FIB正相关;MA与TT负相关;CI值与INR负相关,与FIB正相关;LY30与常规凝血指标无明显相关性。结论:血栓弹力图对不典型膜性肾病患者能全面的检测和评估体内凝血的发生、发展,与常规凝血试验进行综合分析能起到互补作用,指导临床抗凝治疗。

Objective：To investigate the correlation between the thrombelastogram and conventional coagulation tests in patients with atypical membranous nephropathy,and evaluate the two methods＇commonness differences in determining the blood coagulation test of atypical membranous nephropathy.Method：Select 120 cases of Nephrology in the people＇s hospital of Cangzhou city.There were 60 cases in AMN group and 60 cases in chronic nephritis group,all patients underwent routine coagulation test and TEG test.Result：The R values of AMN and chronic glomerulonephritis were （5.41 ±0.65）min and （6.40 ±1.56）min, respectively.K value comparison,（1.11±0.37）min and （2.16±0.58 ）min,respectively.A angles were compared with （71.08±5.93） °and （59.88±5.47） °,respectively.MA value comparison,（71.51±5.58）mm and （60.13±5.02）mm,respectively.Comparison of CI values,（2.23±1.98）and（-0.99±1.14）,respectively.The difference was statistically significant （ P 〈0.05）.There was no significant difference between LY30 （0.99 ±0.37）% and （0.91 ±0.29）%.There was no significant difference between the two groups in the indexes of routine coagulation test （ P 〉0.05）.There was a correlation between the parameters of TEG test and the indexes of routine coagulation test.R value was positively correlated with PTT INR and negatively correlated with FIB.K value was positively correlated with PTT INRTTT and negatively correlated with FIB.A angle and MA were positively correlated with FIB.There was a negative correlation between MA and TT.CI was negatively correlated with INR and positively correlated with FIB.There was no significant correlation between LY 30 and conventional coagulation parameters.Conclusion ：Thromboelastogram can detect and evaluate the occurrence and development of coagulation in vivo in patients with atypical membranous nephropathy.Comprehensive analysis with conventional coagulation test can play a complementary role in guiding clinical anticoagulant therapy. Key words