急性心肌梗死患者血栓弹力图与纤维蛋白原、血小板平均体积的相关性研究

Correlation between thromboelastogram,fibrinogen and mean platelet volume in patients with acute myocardial infarction

目的分析和比较急性心肌梗死(AMI)患者血栓弹力图(TEG)与纤维蛋白原(FIB)、血小板平均体积(MPV)等指标的相关性。方法选择收治的120例AMI患者为研究对象,进行回顾性横断面调查研究。根据AMI后有无心力衰竭表现及其相应的血流动力学改变严重程度,按Killip分级法分为四级,其中Ⅰ级30例,Ⅱ级46例,Ⅲ级32例,Ⅳ12例。同期入组50例健康体检者作为对照组。收集患者住院期间一般资料、TEG指标、FIB、MPV等,分析TEG、FIB、MPV在各组间的差异,采用Pearson相关系数分析急性心肌梗死患者TEG指标与FIB、MPV等之间的相关性。结果AMI组TEG指标中ɑ角、MA、CI、FIB、MPV值明显高于对照组,差异有统计学意义(P<0.05);R值和K值明显低于对照组,差异有统计学意义(P<0.05)。AMI组各组TEG指标中R值、K值随着心功能分级增高而逐渐降低,ɑ角、MA值及FIB、MPV值随着心功能分级增高而逐渐升高,组间比较差异有统计学意义(P<0.05)。R值与FIB呈负相关性(r=-0.265),K值与MPV呈负相关性(r=-0.310),ɑ角与MPV呈正相关性(r=0.195);MA与FIB呈正相关性(r=0.206),与MPV呈正相关性(r=0.188),差异有统计学意义(P<0.05)。结论AMI患者TEG与FIB、MPV指标均具有一定的相关性,TEG各参数可有效反映AMI患者病情程度,可用于监测病情和指导疾病治疗。

Objective To analyze and compare the correlation between thromboelastogram(TEG),fibrinogen(FIB)and mean platelet volume(MPV)in patients with acute myocardial infarction(AMI).Methods A retrospective cross-sectional study was conducted on 120 patients with AMI.According to the presence of heart failure and the severity of hemodynamic changes after AMI,the method of Killip classification was used and the patients were divided into four levels,including 30 cases of grade Ⅰ,46 cases of grade Ⅱ,32 cases of grade Ⅲ and 12 cases of grade Ⅳ.At the same time,50 healthy subjects were enrolled as the control group.The general data,TEG index,FIB,MPV of patients were collected during the hospitalization.The differences of TEG index,FIB and MPV in each group were analyzed,and Pearson correlation coefficient was used to analyze the correlation between TEG index and FIB and MPV in patients with acute myocardial infarction.Results The index of TEG,includingɑAngle,MA,CL,FIB,MPV value in AMI group was significantly higher than that in the control group(P<0.05).The R and K values in AMI group were significantly lower than those in the control group(P<0.05).The R and K values of TEG indexes in AMI group gradually decreased with the increase of cardiac function grade,and theɑangle,Ma,FIB and MPV gradually increased with the increase of cardiac function grade,and there was significant difference between the groups(P<0.05).The R value was negatively correlated with FIB(r=-0.265),and the K value was negatively correlated with MPV(r=-0.310),ɑAngle was positively correlated with MPV(r=0.195),MA was positively correlated with FIB(r=0.206),and was positively correlated with MPV(r=0.188),with significant difference(P<0.05).Conclusion TEG is correlated with FIB and MPV in patients with AMI.The parameters of TEG can effectively reflect the severity of AMI in patients,and can be used to monitor the condition and guide the treatment of the disease.