血栓弹力图及血小板图在评估颅脑创伤中的价值研究

Study on the value of thrombelastography and platelet mapping in the evaluation of craniocerebral trauma

目的应用血栓弹力图(TEG)及血小板图分析颅脑创伤后TEG参数及血小板功能的改变。方法应用TEG及血小板图在30 min内检测35例颅脑创伤病人及34例健康人的TEG参数及血小板功能的改变。结果与健康对照组比较,颅脑创伤病人凝血因子激活时间(R)、血块形成速率参数(K)、血块溶解速率(LY30)均高于健康对照组,差异有统计学意义(P<0.05);颅脑创伤组弹力图最大切角(α-Angle,α角)、弹力图最大振幅(MA)均低于健康对照组,差异有统计学意义(P<0.05)。颅脑创伤组血小板抑制率明显高于健康对照组。颅脑创伤病人平均ADP抑制率84.8%(IQR 37.4%~96.6%),平均AA抑制率43.2%(IQR 26.4%~59.1%);健康对照组平均ADP抑制率4.7%(IQR 0~17.2%)(P<0.05),平均AA抑制率0.8%(IQR 0~3.14%)(P<0.05)。结论TEG参数及血小板图对颅脑创伤病人的评估具有重要价值。

Objective To analyze the changes of thrombelastography(TEG)parameters and platelet function after traumatic brain injury(TBI)by TEG and platelet mapping.Methods 35 patients with TBI and 34 healthy people were determined within 30 minutes by using TEG and TEG-based platelet functional analysis.Results Compared with the healthy control group,the TEG parameters of the activation time of coagulation factor(R),the blood clot formation rate parameter(K)and the blood clot dissolution rate(LY30)in patients with craniocerebral trauma were significantly higher than those in the healthy control group(P<0.05).Maximum cut angle of elastogram in craniocerebral trauma group(α-Angle),maximum amplitude(MA)were significantly lower than healthy control group(P<0.05).The platelet inhibition rate in craniocerebral trauma group was significantly higher than that in healthy control group.In TBI patients,the median ADP inhibition rate of platelet function was 84.8%(interquartile range,IQR,37.4%~96.6%)and the average AA inhibition rate was 43.2%(IQR 26.4%~59.1%).In the healthy control group,the median ADP inhibition rate was 4.7%(IQR 0%~17.2%,P<0.05),and the average AA inhibition rate was 0.8%(IQR 0~3.14%,P<0.05).Conclusions TEG parameters and platelet mapping have great value for evaluating the patients with craniocerebral trauma.