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儿童血栓弹力图参考区间建立及与常规凝血项目的比较 被引量:16

Establishment of thrombelastography reference interval in children and its comparison with traditional coagulation tests
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摘要 目的建立儿童快速血栓弹力图试验(r TEG)及高岭土血栓弹力图试验(CK-TEG)的参考区间,评价其与常规凝血项目的相关性,并了解CK-TEG在血友病患儿中的应用价值。方法选取242例择期手术儿童、40名健康成人及42例血友病患儿,分别检测其CK-TEG、r TEG及常规凝血项目,儿童按<1个月、1个月~1岁、2~5岁、6~10岁及11~16岁分为4个年龄段。结果 r TEG及CK-TEG参数提示各年龄段儿童较成人偏高凝:Angle、MA、G显著增高(P<0.05),K显著缩短(P<0.05),并与血小板(PLT)、纤维蛋白原(Fib)水平明显相关(P<0.05);ACT、R、LY30分别与凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)明显相关(P<0.05)。血友病患儿CK-TEG各参数均明显异常,存在因子抑制物的患儿的R值明显高于无因子抑制物患儿(P<0.05)。结论血栓弹力图各参数可反映PLT水平、内外源凝血活性、Fib功能及纤溶活性,并有助于筛选存在因子抑制物的血友病患儿。 Objective To establish the reference intervals of rapid thrombelastography(rTEG) and Kaolin thrombelastography(CK-TEG) in children,and to evaluate their correlations with traditional coagulation tests and the role of CK-TEG among children with hemophilia. Methods A total of 242 children undergoing elective surgery,40 healthy adults and 42 children with hemophilia were enrolled,and rTEG,CK-TEG and traditional coagulation tests were performed. All children were classified into <1 month old,1 month old-1 year old,2-5 years old,6-10 years old and 11-16 years old groups. Results Compared with adults,children exhibited more hypercoagulation according to rTEG and CK-TEG parameters(high Angle,MA and G and short K)(P<0.05),and these 4 parameters were also correlated with platelet(PLT) and fibrinogen(Fib)(P<0.05). In addition,ACT,R and LY30 were correlated with prothrombin time(PT),activated partial thromboplastin time(APTT)and D-dimer(DD)(P<0.05). All CK-TEG parameters were abnormal for children with hemophilia,and R with factor inhibitor was higher than that without factor inhibitor(P<0.05). Conclusions The parameters of thrombelastography could reflect the levels of PLT,Fib,coagulation activity and fibrinolysis,and it is helpful to screen coagulation factor inhibitor for children with hemophilia.
作者 夏丽波 简翠 张碧玉 王斌 孙自镛 唐宁 XIA Libo;JIAN Cui;ZHANG Biyu;WANG Bin;SUN Ziyong;TANG Ning(Department of Clinical Laboratory,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,Hubei,China)
出处 《检验医学》 CAS 2017年第2期81-85,共5页 Laboratory Medicine
基金 国家自然科学基金青年基金项目(81200353)
关键词 快速血栓弹力图 高岭土血栓弹力图 儿童 凝血功能 参考区间 Rapid thrombelastography Kaolin thrombelastography Children Coagulation function Reference interval
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