血栓弹力图在评价高危ESRS评分患者凝血功能中的应用价值

The value of thromboelastography in the evaluation of coagulation function in high risk ESRS patients

目的探讨血栓弹力图在评价高危Essen卒中风险分层量表(ESRS)评分患者凝血功能中的应用价值。方法收集2017年9月—2019年8月急性大动脉粥样硬化型脑梗死患者119例,入院后完成血栓弹力图和一般凝血指标检测,同时行ESRS评分,记录患者临床资料和实验室检查结果。根据ESRS评分分为低危组43例、高危组39例及超高危组37例。比较各组患者血栓弹力图指标和一般凝血指标并进行各指标之间相关性分析。结果三组急性脑梗死患者血栓弹力图指标RT、KT比较,超高危组低于高危组和低危组,高危组低于低危组,差异均有统计学意义(P<0.05),且随着ESRS评分增高呈降低趋势(P<0.05);MA、Angle指标比较,超高危组高于高危组和低危组,高危组高于低危组差异均有统计学意义(P<0.05),且随着ESRS评分增高呈升高趋势(P<0.05);三组急性脑梗死患者一般凝血指标PT、ATPP、INR、TT比较,超高危组低于高危组和低危组,高危组低于低危组,差异均有统计学意义(P<0.05),且随着ESRS评分增高呈降低趋势(P<0.05)。血栓弹力图指标RT、KT与一般凝血指标PT、ATPP、INR、TT呈正相关(r=0.43~0.81,P<0.05);MA、Angle与PT、ATPP、INR、TT呈负相关(r=-0.46^-0.79,P<0.05)。结论血栓弹力图能够评价高危ESRS评分患者的凝血功能,ESRS评分越高,血栓弹力图指标越差,患者越处于高凝状态。

Objective To discuss the value of thromboelastography in the evaluation of coagulation function in high risk ESRS scores patients.Methods A total of 119 patients with acute atherosclerotic cerebral infarction from September 2017 to August 2019 were collected.After admission,thromboelastography and general coagulation function indicators were tested,and ESRS scores were performed simultaneously.Clinical data and laboratory examination results were recorded.According to ESRS score,119 patients were divided into low-risk group 43 cases,high-risk group 39 cases and super-high-risk group 37 cases.Thromboelastography and general coagulation function indicators in each group were analyzed and compared.Results RT and KT were compared among the three groups of patients with acute cerebral infarction,The super-risk group was lower than that of the high-risk group and the low-risk group,and the highrisk group was lower than that of the low-risk group,with statistically significant differences(P<0.05).Moreover,a decreasing trend occured with the increasing of ESRS score(P<0.05).MA and Angle were compared among the three groups of patients with acute cerebral infarction,The super-risk group was higher than that of the high-risk group and the low-risk group,and the high-risk group was higher than that of the low-risk group,with statistically significant differences(P<0.05).Moreover,a rising trend occured with the increasing of ESRS score(P<0.05).The comparison of PT,ATPP,INR and TT in the three groups of patients with acute cerebral infarction showed that the super-high-risk group was lower than that of the high-risk group and the low-risk group,and the high-risk group was lower than that of the low-risk group,with statistically significant differences(P<0.05).Moreover,a decreasing trend occurs with the increasing of ESRS score(P<0.05).RT and KT were positively correlated with PT,ATPP,INR and TT(r=0.43~0.81,P<0.05);MA and Angle were negatively correlated with PT,ATPP,INR and TT(r=-0.46^-0.79,P<0.05).Conclusion Thromboelastography can evaluate the coagulation function of high-risk ESRS scores patients.The higher ESRs score is,the worse the index of thromboelastography is,and the more hypercoagulable the patient is.