血栓弹力图在子痫前期凝血功能变化监测中的意义分析

Significance of thromboelastography in monitoring coagulation function in preeclampsia

目的:探究血栓弹力图(TEG)在子痫前期(PE)凝血功能变化监测中的意义。方法:选取2019年7月至2022年6月柳州市妇幼保健院收治的300例PE患者为研究组,根据病情严重程度分为两个亚组:A组(轻度)100例、B组(重度)200例,另选取同期于本院进行产检的100例正常孕晚期妇女作为对照组。检测并比较各组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-D)及血栓弹力图(TEG)各参数如凝血时间(R)、凝固时间(K)、凝固角(α角)、最大振幅(MA);采用Pearson相关系数分析TEG参数与常规凝血试验指标的相关性。结果:B组的R值和K值高于对照组和A组,而B组的α角以及MA值低于对照组和A组(均P<0.05);FIB与α角(r=0.226,P=0.035)、MA(r=0.256,P=0.029),TT与R(r=0.292,P=0.018)、α角(r=-0.245,P=0.032)具有相关性。结论:TEG能够有效监测重度合并血小板减少PE患者的凝血功能变化情况,对PE的早期诊治有着重要参考价值。

Objective:To investigate the significance of thromboelastography(TEG)in monitoring coagulation function in preeclampsia(PE).Methods:A total of 300 PE patients admitted to the obstetrics department of Liuzhou Maternity and Child Healthcare Hospital from July 2019 to June 2022 were selected as the study group and divided into two subgroups according to the severity of the disease:Group A(mild)100 cases,group B(severe)200 cases.Another 100 cases of normal late pregnancy women who underwent physical examination in our hospital during the same period were selected as the control group.Activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB),thrombin time(TT),D-Dimer(D-D),thrombelastography(TEG)parameters such as reaction time(R),and kinetics(K),coagulation angle(αangle),maximum amplitude(MA)of clot were detected and compared in each group;pearson correlation coefficient was used to analyze the correlation between TEG parameters and conventional coagulation test indexes.Results:The R value and K value of group B were higher than those of control group and A,while theαAngle and MA value of group B were lower than those of control group and group A(all P<0.05).FIB was correlated withαAngle(r=0.226,P=0.035)as well as MA(r=0.256,P=0.029),and TT was correlated with R(r=0.292,P=0.018)as well asαAngle(r=-0.245,P=0.032).Conclusion:TEG can effectively monitor the changes of coagulation function in PE patients with severe thrombocytopenia,which has important reference value for early clinical diagnosis and treatment.