肝癌患者血栓弹力图与凝血功能及血小板计数的相关性分析

Correlation analysis of thromboelastography,coagulation function and platelet count in patients with hepatocellular carcinoma

目的探讨血栓弹力图(TEG)、凝血功能及血小板计数(PLT)在肝癌患者诊断中的应用价值及其相关性。方法选取2018年3月至2020年5月在该院确诊为肝癌的患者80例作为试验组,同期体检健康者80例作为对照组。检测两组TEG相关指标、凝血功能参数、D二聚体、PLT等,并分析相关性。结果试验组TEG相关指标反应时间(R)长于对照组,凝固角(Angle)大于对照组,而凝血形成时间(K)短于对照组,凝血最大幅度(MA)及凝血综合指数(CI)小于对照组,差异均有统计学意义(P<0.05);试验组PLT和纤维蛋白原(FIB)水平低于对照组,凝血酶原时间(PT)长于对照组,D二聚体水平均高于对照组,差异均有统计学意义(P<0.05)。相关性分析显示,PT与MA值呈正相关,与Angle、CI呈负相关;活化部分凝血活酶时间(APTT)与K、Angle呈正相关;凝血酶时间(TT)与CI呈正相关,与Angle呈负相关;FIB与MA和CI呈正相关;PLT与MA呈正相关。结论TEG不仅能够全程反映肝癌患者体内的凝血功能情况,也与常规凝血功能检查和PLT有关,联合检测有利于准确评估肝癌患者凝血状态,从而了解病情、对症治疗。

Objective To investigate the value and correlation of thrombolysis diagram(TEG),coagulation function and platelet count(PLT)in the diagnosis of liver cancer patients.Methods From March 2018 to May 2020,80 patients diagnosed with liver cancer in the hospital were selected as experimental group,and 80 healthy subjects during the same period were selected as control group.TEG related indicators,coagulation function parameters,D-dimer and PLT were detected in the two groups,and the correlation among them was analyzed.Results Reaction time(R)of TEG related indexes in experimental group was longer than that in control group,coagulation Angle(Angle)was larger than that in control group,while coagulation formation time(K)was shorter than that in control group,the maximum coagulation(MA)and coagulation composite index(CI)were smaller than those in control group,the differences were statistically significant(P<0.05).PLT and fibrinogen(FIB)level in experimental group were lower than those in control group,prothrombin time(PT)was longer than that in control group,and D-dimer level was higher than control group,the differences were statistically significant(P<0.05).Correlation analysis showed that PT was positively correlated with MA,and negatively correlated with Angle and CI;APTT was positively correlated with K and Angle;thrombin time(TT)was positively correlated with CI,and negatively correlated with Angle;FIB was positively correlated with MA and CI,and PLT was positively correlated with MA.Conclusion TEG can not only reflect the coagulation function of patients with liver cancer in the whole process,but also related to routine coagulation function test and PLT.Combined detection is beneficial to accurately evaluate the coagulation status of patients with liver cancer,so as to understand the disease and symptomatic treatment.