体检人群中无创血流动力学、肢体动脉硬化度异常者血栓弹力图的变化

The changes of Thrombelastography in physical examination people with abnormal noninvasive hemodynamics and limb arteriosclerosis

目的探讨体检人群中无创血流动力学及肢体动脉硬化度异常者的血栓弹力图(TEG)各指标的变化情况。方法选择2017年1月至7月至我院体检中心体检并行TEG检查的人群共1572人,其中行无创血流动力学检查者722人,行肢体动脉硬化度检查者750人。用TEG 5000检测仪行快速检测,将体检结果异常者与正常者的凝血状态进行对照,检测K值、Angle角、MA值、ACT,对两组间TEG的各值进行比较,同时分析男、女间各值的差别。结果在男性中,无创血流动动力学异常者相较于正常者的K值偏短、Angle角偏大,且差异均有统计学意义(P<0.05),但在女性中,两组间各参数均无显著差异;肢体动脉硬化度检查异常者无论男性或女性ACT值均偏低,差异有统计学意义(P<0.05)。女性较男性Angle角大、K值低、MA值高,差异有统计学意义(P<0.05)。结论女性较男性更易出现血栓。在男性中,无创血流动力学异常者较正常者血液呈现高凝状态;但在女性中,两组人群体内的凝血状态相似。肢体动脉硬化度异常者较正常者无论男性或女性血液呈现高凝状态,TEG可用来观察结果异常者的凝血状态变化,为临床诊疗提供参考依据。

Objective To investigate the significance of Thrombelastography（TEG） in monitoring coagulation status among physical examination people with abnormal noninvasive hemodynamics and limb arteriosclerosis.Methods A total of 1572 people were examined by physical examination at Wuhan Union Hospital from January to july,2017,722 people performed noninvasive hemodynamic and 750 people were examined for arteriosclerosis of the extremities.Rapid detection by TEG 5000,the coagulation status of the crowd with abnormal physical examination results was compared with that of the normal subjects,the parameters of K value,angle A value,MA value,ACT value between the two groups were compared,meanwhile,the difference of parameters between male and female were analyzed.Results In men,the K value of noninvasive hemodynamics was shorter than that of normal ones,and the Angle angle was larger（P〈0.05）;However,there was no significant difference in the parameters among the two groups in women.The ACT value was significantly lower in abnormal results compared to normal subjects within limb arteriosclerosis among physical examination people（P〈0.05）.Female compared with male,angle A was bigger,K was shorter and MA was higher,all of them had statistical significance（P〈0.05）.Conclusion Women are more likely to occurre thrombosis than men.In men,noninvasive hemodynamic abnormalities were more hypercoagulable than those in normal subjects,but in women,the coagulation state in two groups was similar.All men and women,those with abnormal limb arteriosclerosis showed hypercoagulable state.TEG could be used to detect the early coagulation function of the crowd with abnormal noninvasive hemodynamics and limbarteriosclerosis,providing reference for clinical diagnosis and treatment.