血栓弹力图在评价高危ESRS评分患者凝血功能和早期神经功能恶化的价值探讨

Discussion the value of thromboelastography on evaluating coagula tion function and early neurological delerioration in high-risk ESRS scores patients

目的探讨血栓弹力图在评价高危ESRS评分患者凝血功能和早期神经功能恶化(END)的价值。方法收集2017年9月-2019年12月急性大动脉粥样硬化型脑梗死患者158例,入院后完成血栓弹力图检测,同时行ESRS评分,入院3 d内发生神经功能恶化的患者为END,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56例、高危组53例及超高危组49例。分析比较各组患者END发生率、血栓弹力图指标,建立Logistic回归模型分析血栓弹力图参数与END的关系。结果三组急性脑梗死患者END发生率比较,超高危组最高,低危组最低,差异有统计学意义(P<0.01);三组急性脑梗死患者血栓弹力图指标RT、KT比较,超高危组最低,低危组最尚,差异有统计学意义(P<0.01);MA、Angle指标比较,超南危组最南,低危组最低,差异有统计学意义(P<0.01);Logistic回归分析显示,RT与END发生独立相关(OR=1.71,95%CI:1.09~2.46,P<0.01)。结论血栓弹力图能够评价高危ESRS评分患者的凝血功能,RT对高危ESRS评分患者发生早期神经功能恶化有一定预测价值。

Objective To investigate the value of thromboelastography on evaluating coagulation function and early neurological delerioration in high-risk ESRS scores patients.Methods A total of 158 patients with acute atherosclerotic cerebral infarction from September 2017 to December 2019 were collected.After admission,thromboelastography and ESRS scores were performed simultaneously.The patients with neurological deterioration within 3 days of admission were labeled as early neurological delerioration(END).According to ESRS score,158 patients were divided into low-risk group 56 cases,high-risk group 53 cases and super-high-risk group 49 cases.The END incidence rate and Thromboelastography of each group were analyzed and compared,and a Logistic regression model was established to analyze the relationship between Thromboelastography and END.Results Compared with the three groups of patients with acute cerebral infarction,the END incidence rate in the super-high-risk group was higher than that in the high-risk group and the low-risk group,and the high-risk group was higher than that in the low-risk group(P<0.01),with statistically significant differences(P<0.01).RT and KT were compared among the three groups of patients with acute cerebral infarction,The super-risk group was lower than the high-risk group and the low-risk group,and the high-risk group was lower than the low-risk group(P<0.01),with statistically significant differences(P<0.01).MA and Angle were compared among the three groups of patients with acute cerebral infarction,The super-risk group was higher than the high-risk group and the low-risk group,and the high-risk group was higher than the low-risk group(P<0.01),with statistically significant differences(P<0.01).Logistic regression analysis showed that RT was independently correlated with END(0R=1.71,95%CI:1.09〜2.46,P<0.01).Conclusion Thromboelastography can evaluate the coagulation function of high-risk ESRS scores patients,and RT has a certain predictive value for END in high-risk ESRS scores patients.