血栓弹力图对急性冠状动脉综合征患者的诊断价值

Diagnostic Value of Thromboelastography in Patients with Acute Coronary Syndrome

目的探讨血栓弹力图(TEG)对急性冠状动脉综合征(ACS)患者的诊断价值。方法以80例ACS患者为对观察组,以同期60例健康人群为对照组。检测患者血栓弹力图(TEG)参数,分析其诊断ACS的价值。结果观察组K值低于对照组,Angle角、MA值、CI值高于对照组(P<0.05)。K值诊断ACS的AUC、敏感度、特异性、最佳截断点分比为0.816(9%CI:0.747~0.873)、86.25%、66.25%、2.25 min;Angle诊断ACS的AUC、敏感度、特异性、最佳截断点分别为0.834(95%CI:0.767~0.888)、75.00%、80.00%、60.72°;MA值诊断ACS的AUC、敏感度、特异性、最佳截断点分别为0.823(95%CI:0.755~0.879)、90.00%、60.00%、56.17 mm;CI值诊断ACS的AUC、敏感度、特异性、最佳截断点分别为0.844(95%CI:0.778~0.896)、87.50%、72.50%、1.18。R、Angle、MA、CI联合诊断ACS的AUC、敏感度、特异性分别为0.971(95%CI:0.931~0.991)、89.34%、93.48%。K值、Angle、MA值、CI诊断ACS的AUC比较无差异(P>0.05),联合检测诊断ACS的AUC高于四项指标单独诊断(P<0.05)。结论ACS患者凝血功能存在亢进,TEG监测有助于早期诊断ACS。

Objective To investigate the diagnostic value of thromboelastography(TEG)in patients with Acute Coronary Syndrome(ACS).Methods 80 patients with ACS were taken as the observation group and 60 healthy people as the control group.The parameters of TEG were measured and the value of TEG in the diagnosis of ACS was analyzed.Results The K value of observation group was lower than that of Control Group,Angle,Ma value and CI value were higher than that of Control Group(P<0.05).The AUC,sensitivity,specificity and optimal cut-off point ratio of K value in the diagnosis of ACS were 0.816(9%CI:0.747~0.873),86.25%,66.25%,2.25 min;The AUC,sensitivity,specificity and Best cut-off point of Angle diagnosis of ACS were 0.834(95%CI:0.767~0.888),75.00%,80.00%and 60.72°,respectively The AUC,sensitivity,specificity and optimal cut-off point of Ma were 0.823(95%CI:0.755~0.879),90.00%,60.00%and 56.17mm,respectively The AUC,sensitivity,specificity and Best cut-off point of CI were 0.844(95%CI:0.778~0.896),87.50%,72.50%and 1.18 respectively.The AUC,sensitivity and specificity of Combined Diagnosis of ACS with R,Angle,Ma and CI were 0.971(95%CI:0.931~0.991),89.34%and 93.48%,respectively.There was no significant difference in the AUC of ACS.Between K value,Angle,Ma value and CI(P>0.05).The AUC of combined detection of ACS was higher than that of four indexes alone(P<0.05).Conclusion There is hypercoagulability in patients with ACS.TEG monitoring is helpful for early diagnosis of ACS.