外周血PLR、FIB联合血栓弹力图在肺炎合并2型糖尿病患者高凝状态评估中的应用

Application of Peripheral Blood PLR and FIB Combined with Thromboelastography in the Evaluation of Hypercoagulability in Patients with Pneumonia and Type 2 Diabetes Mellitus

目的探究外周血血小板/淋巴细胞比值(PLR)、血浆纤维蛋白原(FIB)联合血栓弹力图(TEG)在肺炎合并2型糖尿病患者高凝状态评估中的价值。方法选取2020年1月—2021年12月就诊的90例肺炎合并2型糖尿病为研究对象,将并发栓塞的患者设为高凝组38例,未发生栓塞的患者设为非高凝组52例。比较2组TEG参数[R时间、K时间、Angle角、凝血指数(CI)、最大振幅(MA)值]、常规凝血检查(CCTs)指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、FIB]及PLR。采用Spearman相关性分析CCTs指标、PLR与TEG参数之间的关系,受试者工作特征(ROC)曲线分析FIB、PLR与TEG参数联合评估肺炎合并2型糖尿病患者高凝状态的价值。结果高凝组PLR、Angle角、CI、MA值、PT、APTT、FIB水平均高于非高凝组,R时间、K时间均短于非高凝组(P<0.01)。Spearman相关性分析显示,TEG参数R时间、K时间分别与PLR、PT、APTT、FIB呈负相关性(P<0.01),Angle角、CI、MA值分别与PLR、PT、APTT、FIB呈正相关性(P<0.01);ROC曲线分析显示,FIB、PLR、TEG参数及三者联合检测评估肺炎合并2型糖尿病患者高凝状态的曲线下面积分别为0.724、0.751、0.905、0.916。结论TEG参数与CCTs指标、PLR具有相关性,三者联合应用可较好反映肺炎合并2型糖尿病患者的高凝状态,可用于该疾病并发栓塞的诊断。

Objective To explore the application value of peripheral blood platelet/lymphocyte ratio(PLR)and plasma fibrinogen(FIB)combined with thromboelastography(TEG)in the evaluation of hypercoagulability in patients with pneumonia and type 2 diabetes mellitus(T2DM).Methods Ninety patients with pneumonia and T2DM treated from January 2020 to December 2021 were selected as the research subjects.Of them,38 patients with embolism were set as the hypercoagulability group,and 52 patients without embolism were set as the non-hypercoagulability group.TEG parameters[R time,K time,αangle,coagulation index(CI),the maximum amplitude(MA)],indexes of conventional coagulation tests(CCTs)[prothrombin time(PT),activated partial thromboplastin time(APTT),FIB]and PLR were compared between the two groups.Spearman correlation was used to analyze the correlation between CCTs,PLR and TEG parameters,and the receiver operating characteristic(ROC)curve was used to analyze the application value of FIB,PLR and TEG parameters in evaluating the hypercoagulable state of patients with pneumonia and T2DM.Results The levels of PLR,αangle,CI,MA,PT,APTT and FIB in the hypercoagulability group were higher than those in the non-hypercoagulability group,and the R time and K time were lower than those in the non-hypercoagulability group(P<0.01).Spearman correlation analysis showed that the TEG parameters R time and K time were negatively correlated with PLR,PT,APTT and FIB,respectively(P<0.01),andαangle,CI and MA values were positively correlated with PLR,PT,APTT and FIB,respectively(P<0.01).ROC curve analysis showed that the area under the ROC curve of FIB,PLR,TEG parameters and combined detection for evaluating the hypercoagulability of patients with pneumonia and T2DM were 0.724,0.751,0.905 and 0.916,respectively.Conclusion TEG parameters are of important correlation with indexes of CCTs indexes and PLR.The combined detection of CCTs indexes,PLR and TEG parameters can well reflect hypercoagulability in patients with pneumonia and T2DM,which can be applied in the diagnosis of embolism.