军队干部脑梗死患者血栓弹力图与危险因素分析

Risk factors and TEG in veteran patients with cerebral infarctions

目的探讨军队干部脑梗死患者的高凝状态与致病主要危险因素之间的关系。方法选取2016-01至2017-07干部病房住院的急性脑梗死的军队干部200例为军干组,另选取50岁以上军队体检干部200名为对照组,回顾性分析脑梗死8个主要危险因素,并应用血栓弹力图(thrombelastograph,TEG)对军干组和对照组患者进行凝血功能检测,应用两样本t检验及Logistic回归方程分析主要致病危险因素与TEG的关系。结果军干组和对照组的TEG指标中R值(t=5. 472)、K值(t=7. 434)、α角(t=7. 531)、MA值(t=6. 997)差异均有统计学意义;两组危险因素中吸烟(χ~2=4. 64,P=0. 031)、酗酒(χ~2=6. 17,P=0. 013)、超负荷工作时间(χ~2=4. 48,P=0. 034)差异均有统计学意义,饮茶、失眠、饮水量、高盐饮食、脑卒中家族史均无统计学意义;各危险因素对军干组TEG指标的影响大小依次为吸烟、酗酒、失眠、高盐饮食、脑梗死家族史,饮茶是保护因素。结论军队干部患急性脑梗死的血液处于高凝状态,吸烟、酗酒、失眠、高盐饮食等不良嗜好和习惯易导致高凝状态的形成,而饮茶可以减少高凝状态的形成。

Objective To analyze the hypercoagulable state and risk factors in patients with acute cerebral infarction( CI) among military officers using thromboelastography. Methods A total of 200 military officers with acute cerebral infarctions admitted to our department between January 2016 and July 2017 were selected as the case group,while another 200 military officers over 50 years old and under health checkups were selected as the control group. Eight primary risk factors for cerebral infarctions were retrospectively analyzed,and thromboelastography was used to detect coagulation function in patients in the two groups. Two sample t test and logistic regression equation were used to analyze the relationships between the main risk factors and TEG. Results There was significant difference in such TEG parameters as R values( t = 5. 472,P < 0. 001),K values( t = 7. 434,P < 0. 001),α-Angle( t = 7. 531,P <0. 001) and MA values( t = 6. 997,P < 0. 001) between the two groups. There was statistically significant difference in such risk factors as smoking( χ~2= 4. 64,P = 0. 031),excessive drinking( χ~2= 6. 17,P = 0. 013) and working overtime( χ~2= 4. 48,P = 0. 034)between the two groups. However,there was no statistically significant difference in tea drinking,insomnia,amount of water drinking,high-salt diet or family history of stroke. Among these risk factors,smoking had the strongest influence on TEG indexes of the case group,followed by drinking,insomnia,high salt diet and a family history of cerebral infarction,while tea drinking was a protection factor. Conclusions The blood of patients with acute cerebral infarction among military officers is hypercoagulable. Long-term smoking,drinking,insomnia,and high-salt diet may accelerate the formation of the hypercoagulable state,and tea drinking can reduce the formation.