TEG与常规凝血试验检测下肢深静脉血栓患者凝血功能结果的相关性和一致性研究

A study on correlation and consistency of the results of coagulation function detected by TEG and routine coagulation test for patients with lower extremity deep venous thrombosis

目的探讨下肢深静脉血栓(DVT)患者血栓弹力图实验(TEG)检测与常规凝血试验检测结果的相关性与一致性。方法对2017年9月至2021年1月安徽医科大学附属合肥医院介入科收治的87例DVT住院患者TEG与常规凝血试验检测结果进行回顾性分析,对二者结果进行统计学分析。结果TEG检测中相关参数与常规凝血试验检测指标具有明显相关性,TEG的R值与凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)呈正相关(r=0.231,r=0.395);TEG的K值与APTT呈正相关(r=0.237),与纤维蛋白原(FIB)、血小板计数(PLT)呈负相关(r=-0.521,r=-0.431);TEG的α-angle与FIB、PLT值呈正相关(r=0.542,r=0.471);TEG的MA值与FIB、PLT值呈正相关(r=0.674,r=0.596),差异均有统计学意义(P<0.05)。对凝血状态的判断,TEG的MA值与PLT、FIB具有一致性(Kappa=0.148,Kappa=0.210;P<0.05)。结论对于DVT患者,其TEG检测与常规凝血试验检测呈现显著相关性,但二者一致性较差,两种方法尚无法相互替代。TEG提供了常规凝血试验之外的补充信息,值得在临床推广应用。

Objective To investigate the correlation and consistency of the detection results between thromboelastography(TEG)and routine coagulation test in patients with lower extremity deep venous thrombosis(DVT).Methods The detection results of TEG and routine coagulation test in eighty-seven DVT inpatients admitted to the Department of Intervention,Hefei Hospital Affiliated to Anhui Medical University from September 2017 to January 2021 were retrospectively analyzed,and the detection results of the two different methods were statistically analyzed.Results There was a significant correlation between the relevant parameters of TEG and the detection indicators of routine coagulation test.The R value of TEG was positively correlated with prothrombin time(PT)and activated partial thromboplastin time(APTT)(r=0.231,r=0.395).The K value of TEG was positively correlated with APTT(r=0.237),and negatively correlated with fibrinogen(FIB)and platelet count(PLT)(r=-0.521,r=-0.431).Theα-angle of TEG was positively correlated with the values of FIB and PLT(r=0.542,r=0.471),and the value of MA of TEG was positively correlated with the values of FIB and PLT(r=0.674,r=0.596),and the differences were significant(P<0.05).For the judgment of coagulation state,the MA value of TEG is consistent with PLT and FIB(Kappa=0.148,Kappa=0.210;P<0.05).Conclusion For DVT patients,there is a significant correlation between TEG detection and routine coagulation test detection,but the consistency between the two methods is poor,and the two methods can not replace each other.TEG provides additional information besides that provided by routine coagulation test and is worthy of further clinical application.