血栓弹力图检测在下肢动脉硬化闭塞症中的应用研究

Study on application of value of thrombus figure in patients with lower extremities atherosclerosis disease

目的:探讨血栓弹力图(TEG)检测在下肢动脉硬化闭塞症凝血功能的作用。方法:选取2017-01—2017-12治疗的99例下肢动脉硬化闭塞症患者,根据病程将其分为3组(轻度病变组、中度病变组和重度病变组);选择同期入院的40例健康者作为对照组。所有研究对象均进行TEG与凝血常规及血小板含量检测并分析其相关性。TEG参数与动脉硬化闭塞症不良事件进行相关性分析。结果:轻度病变组R值和K值低于对照组,差异有统计学意义(P<0.05);中度病变组Angle角、MA值、FIB值和D-D值明显高于对照组和轻度病变组,差异有统计学意义(P<0.05),中度病变组R值、K值降低,差异有统计学意义(P<0.05);重度病变组R值低于中度病变组,MA值、FIB值和D-D值明显高于中度病变组,差异有统计学意义(P<0.05);相关性分析显示,R值与FIB值、D-D值呈负相关;K值与FIB值、PLT值、D-D值呈负相关;Angle角和MA值分别与FIB、PLT、D-D呈正相关。下肢动脉硬化闭塞症不良事件相关性分析发现MA与脑血管和截肢有显著相关性。结论:在下肢动脉硬化闭塞症患者中,患者处于高凝状态,与常规凝血检查相比,TEG能更好的反映患者血液状态。

Objective:To explore the application of thromboelastogram(TEG)on coagulation function in the patients with lower extremities atherosclerosis disease. Method:A total of 99 ASO patients who were treated in this hospital from January 2017 to December 2017 were selected and divided into three groups according to their course of disease,namely mild-disease group,moderate-disease group and severe-disease group;and 40 healthy people that admitted to hospital at the same period were selected as control group.TEG,routine coagulation detection and platelet content were taken for all subjects,and the correlation was analyzed.Correlation analysis was performed between the paremeters of TEG and adverse events in arteriosclerosis obliterans. Result:R value and K value of the mild-disease group were less than those of the control group,and the difference was statistically significant(P<0.05).K value,MA value,FIB value and D-D value of the moderate-disease group were significantly higher than those of the mild-disease group and control group,and the difference was statistically significant(P<0.05).R value and Angle of the moderate-disease group decreased,and the difference was statistically significant(P<0.05).R value of the severe-disease group were less than that of the moderate-disease group,MA value,FIB value and D-D value of the severe-disease group were significantly higher than those of the moderate-disease group,and the difference was statistically significant(P<0.05).Correlation analysis showed that R value was negatively correlated with FIB value and D-D value;K value was negatively correlated with FIB value,PLT value and D-D value;Angle and MA value were positively correlated with FIB value,PLT value and D-D value,respectively.Association analysis of adverse events in lower limb arteriosclerosis obliterans found that MA was significantly correlated with cerebral vascular events and amputations.Conclusion:ASO patients were in hypercoagulable state,and TEG could better reflect the blood status of patients,comparing with the conventional coagulation test.