血栓弹力图在预测腔隙性脑梗死发展为进展性脑梗死的价值

Clinical value of thrombelastography in predicting the lacunar stroke developing into progressive lacunar stroke

目的:探讨血栓弹力图(TEG)在预测腔隙性脑梗死(LS)发展为进展性脑梗死(PLS)中的作用。方法:选取LS病人142例,根据是否发展为PLS分为PLS组(46例)与无进展性腔隙性脑梗死组(Non-PLS组)(96例)。采用TEG5000型分析仪检测最大振幅、凝固角、凝固时间与反应时间等TEG参数。结果:PLS组最大振幅、凝固角明显大于Non-PLS组,凝固时间、反应时间明显短于Non-PLS组(P<0.01)。Pearson直线相关分析显示,最大振幅、凝固角与PLS病人NHISS评分呈正相关(P<0.05),凝固时间、反应时间与PLS病人NHISS评分呈负相关(P<0.01)。logistic回归分析显示,最大振幅、凝固角可作为LS发展为PLS的独立危险因素,凝固时间、反应时间可作为LS发展为PLS的独立保护因素(P<0.05~P<0.01)。结论:TEG在预测LS发展为PLS中的作用显著,其中最大振幅、凝固角越大,凝固时间、反应时间越短则预测LS发展为PLS的风险越大。

Objective: To investigate the clinical value of thrombelastography( TEG) in predicting the lacunar stroke( LS) developing into progressive lacunar stroke( PLS).Methods: One hundred and forty-two LS patients were divided into the PLS group( 46 cases) and Non-PLS group( 96 cases).The maximum amplitude,clotting angle,clotting time and reaction time of TEG parameters in two groups were detected using TEG5000 analyzer.Results: The maximum amplitude and clotting angle in PLS group were significantly larger than those in Non-PLS group( P < 0.01),and the clotting time and reaction time in PLS group were significantly shorter than those in Non- PLS group( P < 0.01).The results of Pearson linear correlation analysis showed the maximum amplitude and clotting angle were positively correlated with NHISS score of PLS patients( P < 0.05),and the clotting time and reaction time were negatively correlated with NHISS score of PLS patients( P < 0.01).The logistic regression analysis showed that the maximum amplitude and clotting angle could be used as the independent risk factors of the LS developing into PLS,and the clotting time and reaction time could be used as independent protective factors of the LS developing into PLS( P < 0.05 to P < 0.01).Conclusions: The value of TEG in the prediction of the LS developing into PLS is obvious.The larger the maximum amplitude and clotting angle are,and the shorter the clotting time and reaction time are,the higher the risk of the LS developing into PLS is.