血栓弹力图肝素酶对比试验在下肢深静脉血栓中的应用

Analysis of correlations between hmTEG and conventional coagulation test in deep vein thrombosis

目的:研究血栓弹力图肝素酶对比试验(hmTEG)指标在下肢深静脉血栓(DVT)患者上是否存在差异,探讨常规凝血功能指标与hmTEG在诊断DVT上是否存在相关性,监测患者体内是否有肝素残留,指导临床用药治疗。方法:选取2018-01—2018-06就诊的患者,试验组为57例新发急性期DVT患者,对照组为57例同期来医院常规体检人员。2组均行常规凝血功能检查以及枸橼酸化高岭土激活样品TEG检测,而试验组另行下肢深静脉超声检查,患者经治疗后行枸橼酸化高岭土激活样品肝素酶杯TEG检测。结果:试验组在TEG指标包括凝血反应时间R值、凝固时间K值、最大血凝块强度MA值、凝固角α值上的差异均有统计学意义(均P <0.05),且常规凝血指标包括活化部分凝血活酶时间(APTT),凝血酶原时间(PT)、D-二聚体(D-D)与R值具有相关性;PT、APTT、D-D与K值具有相关性;PT与α值具有相关性;APTT、D-D与MA值具有相关性。经治疗后,57例患者中5例提示肝素残留,52例提示肝素未存在或未起效。结论:DVT患者的hmTEG相关指标差异有统计学意义,对于评估DVT患者具有一定的实用价值。在诊断下肢深静脉血栓DVT方面,TEG相关指标与常规凝血指标具有一定相关性,且hmTEG能更好的指导临床用药。

Objective:To investigate whether there is a difference in thrombus and elastic index(hmTEG)in patients with deep venous thrombosis(DVT),and explore whether there is a correlation between hmTEG and the conventional coagulation index.Method:A total of 57 DVT patients in First Affiliated Hospital of Harbin Medical University from January 2018 to June 2018 were selected as the experimental group,and other 57 healthy people were selected as the control group.During the selection process of the experimental group,some new acute patients were selected.The control group and the experimental group taken conventional coagulation detection and CK-TEG detection,and the experimental group received deep venous ultrasound examination of the lower extremities.After treatment,the experimental group received hmTEG detection.Result:The differences of R value,K value,MA value andαvalue between the experimental group and control group were statistically significant(P<0.05).In addition,the activation of partial thromboplastin time(APTT),prothrombin time(PT)and D-dimer were closely related to R value;PT,APTT and D-dimer had great correlation with K value;PT andαvalue had great correlation;APTT,D-dimer and MA value had strong correlation.Conclusion:There were significant differences in thromboelastin related indexes in DVT patients,which was of practical value for the assessment of DVT patients.TEG related indexes were related to the diagnosis of deep venous thrombosis of the lower extremities,which might have agood complementary effect on the diagnosis of deep venous thrombosis of the lower extremities,and could better distinguish the risk of blood and coagulation test.