脑梗死患者血栓弹力图与血小板指标的相关性

Correlation of thromboelastography and platelet index in patients with cerebral infarction

目的:分析脑梗死患者血栓弹力图(thromboelastography,TEG)、血小板指标检测的临床价值并探究其相关性。方法:纳入2018年2月至2020年2月在中国人民解放军联勤保障部队第九0四医院接受诊治的172例脑梗死患者为研究对象,根据患者病因分为Ⅰ组和Ⅱ组。Ⅰ组为大动脉粥样硬化患者,Ⅱ组为小血管闭塞患者。另外,选择同期于我院接受体检的172例健康者为对照组。受试者均接受TEG与血小板指标检验,分析并比较各组血小板、TEG指标,分析二者的相关性。结果:Ⅰ组血小板、TEG指标与对照组差异有统计学意义(P<0.05);Ⅱ组患者血小板、TEG指标与对照组差异无统计学意义(P>0.05);Ⅰ组血小板体积分布宽度、大血小板占比、血小板平均体积高于对照组(P <0.05)。3组M A值、血小板数量差异无统计学意义(P> 0.05)。相关性分析发现:在脑梗死患者中,随着TEG中R值增高,血小板平均体积、大血小板占比相应降低,而MA值越高,血小板体积越大(P<0.05)。结论:TEG中R值与血小板平均体积、大血小板占比呈负相关,MA值与血小板体积呈正相关,TEG可在一定程度上反映血小板功能,为临床上诊治疾病提供参考数据,值得运用与推广。

Objective: To analyze the clinical value of thromboelastography and platelet index in patients with cerebral infarction, and to explore the correlation. Methods: A total of 172 patients with cerebral infarction treated in Unsla 904 Hospital from February 2018 to February 2020 were selected. According to the etiology, the patients were divided into a group Ⅰ, caused by atherosclerosis, and a group Ⅱ, caused by occlusion of small blood vessels. A total of 172 healthy persons who received medical examinations in our hospital during the same period were selected as the control group. They all received thrombus elasticity chart and platelet index tests, and the difference of index changes between the two groups were compared and the correlation was analyzed. Results: The results showed that the platelet and TEG indexes in group Ⅰ were significantly different from those in the control group(P<0.05), and there was no significant difference between the group Ⅱ and the control group(P>0.05). In the platelet indexes, the platelet volume distribution width, the proportion of large platelet and the average platelet volume in group Ⅰ were higher than those in the control group(P<0.05). There was no significant difference in MA and platelet count among the three groups(P>0.05). Correlation analysis found that with the increase of R value, the mean platelet volume and the proportion of large platelets in thromboelastic graph test of cerebral infarction patients decreased correspondingly, while the higher MA value, the larger platelet volume(P<0.05). Conclusion: R value is negatively correlated with average platelet volume and large platelet proportion. MA value is positively correlated with average platelet volume. To some extent, thromboelastography can reflect platelet index, which can provide reference data for clinical diagnosis and treatment, which is worthy of application and promotion.