血栓弹力图与常规凝血试验联合应用于下肢静脉栓塞筛查的研究

Study on the application of thromboelastogram and routine coagulation test in the screening of lower extremi⁃ty venous embolism

目的探讨联合应用血栓弹力图(TEG)与常规凝血试验在下肢静脉栓塞筛查方面的关联性研究。方法随机抽选140例同时做常规凝血试验和TEG的血管外科住院患者,根据是否产生血栓分为下肢深静脉血栓组和对照组,比较两组的常规凝血功能指标和TEG结果,并进行相关性分析。结果下肢深静脉血栓组中初始纤维蛋白形成的时间(R)值、纤维蛋白原(Fib)值、D-D二聚体(D-D)水平明显高于对照组,差异均有统计学意义(t分别=3.44、5.56,H=58.38,P均<0.05)。相关性分析显示,TEG中R值与常规凝血实验中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、、D-D呈正相关(r分别=0.32、0.47、0.21,P均<0.05),最大振幅(MA)值和Ang角与Fib呈正相关(r分别=0.52、0.22,P均<0.05)。结论联合应用常规凝血试验与TEG检测可以更加准确评估血液凝固状态,排除下肢静脉栓塞等疾病。

Objective To explore the correlation between the combined application of thromboelastogram(TEG)and routine coagulation test in the screening of lower extremity venous embolism.Methods A total of 140 patients in vascu⁃lar surgery who underwent routine coagulation test and thromboelastogram were randomly selected and divided into lower limb venous thrombosis group and control group according to whether they had thrombosis.The results of routine coagula⁃tion function detection and TEG were compared between the two groups,and correlation analysis was conducted.Re⁃sults The time of initial fibrin formation(R),fibrinogen(Fib)and D-D dimer(D-D)in lower limb venous thrombo⁃sis group were significantly higher than those in control group,with statistical significance(t=3.44,5.56,H=58.38,P<0.05).Correlation analysis showed that R value in thrombologram was positively correlated with prothrombin time(PT),activated partial thrombin time(APTT),and D-D in conventional coagulation tests(r=0.32,0.47,0.21,P<0.05).The maximum amplitude value(MA)and Ang angle were positively correlated with Fib(r=0.52,0.22,P<0.05).Conclu⁃sion The combination of conventional coagulation test and TEG test can more accurately evaluate the blood clotting state and exclude the diseases such as lower limb venous embolism.