急性脑梗死患者血栓弹力图与血小板聚集率和D-二聚体相关性研究  

Correlation of thrombelastogram with platelet aggregation rate and D-dimer in patients with acute cerebral infarction

作　　者：周熙琳[1,2] 梁辉[1,2] 黄洁杰[1] 

机构地区：[1]上海交通大学医学院附属新华医院血液科,上海200092 [2]上海交通大学医学院附属新华医院崇明分院老年科,上海202150

出　　处：《上海交通大学学报（医学版）》2013年第4期459-462,467,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：崇明县科委基金(CK-2011-31)~~

摘　　要：目的探讨急性脑梗死患者血栓弹力图(TEG)各项参数与血小板聚集率(PAgT)和D-二聚体之间的相关性。方法选取102例急性脑梗死患者,根据神经功能缺损程度评分标准分为轻度急性脑梗死组(n=41)、中度急性脑梗死组(n=35)和重度急性脑梗死组(n=26);并以50名健康体检者为对照组。所有研究对象均进行TEG参数(包括R值、K值、α角、MA值、CI值)、PAgT和D-二聚体水平检测。结果与正常对照组比较,急性脑梗死组患者的R值和K值明显缩短,α角、MA值和CI值明显增大,D-二聚体和PAgT水平明显升高,差异均有统计学意义(P<0.01)。与中度和轻度脑梗死组比较,重度脑梗死组患者的TEG参数、D-二聚体及PAgT水平差异均有统计学意义(P<0.05);与轻度脑梗死组比较,中度脑梗死组TEG参数和PAgT水平差异也有统计学意义(P<0.05),但D-二聚体水平差异无统计学意义(P>0.05)。Pearson相关性分析显示,D-二聚体和PAgT水平与α角、MA值、CI值呈显著正相关,与R值和K值呈显著负相关(均P<0.01)。结论急性脑梗死患者TEG参数与D-二聚体和PAgT水平存在较强的相关性,TEG在急性脑梗死的诊断、严重程度评价以及高凝状态监测中均具有良好的实用价值。Objective To investigate the correlation of parameters of thrombelastogram （TEG） with platelet aggregation rate （PAgT） and D-dimer in patients with acute cerebral infarction. Methods One hundred and two patients with acute cerebral infarction were selected, and were divided into mild acute cerebral infarction group （n = 41）, moderate acute cerebral infarction group （n = 35） and severe acute cerebral infarction group （ n = 26） according to the scores of severity of neurological deficit. Besides, 50 healthy subjects were served as control group. All subjects were examined with the parameters of TEG （including R value, K value,α angle, MA value and CI value）, PAgT and D-dimer. Results R-value and K value were significantly smaller, α angle, MA value and CI value were significantly larger and the D-dimer and PAgT levels were significantly higher in patients with acute cerebral infarction than in control group （P 〈 0.01）. The parameters of TEG and levels of PAgT and D-dimer in severe acute cerebral infarction group were significantly different from those in mild acute cerebral infarction group and moderate acute cerebral infarction group （P 〈 0.05）. The parameters of TEG and PAgT level in moderate acute cerebral infarction group were significantly different from those in mild acute cerebral infarction group （P 〈 0.05）, while there was no significant difference in D-dimer level between these two groups （ P 〉 0.05）. Pearson correlation analysis revealed that the D-dimer and PAgT levels were positively related to α angle, MA value and CI level （P 〈 0.01）, and were negatively related to R-value and K value （ P 〈 0.01）. Conclusion The parameters of TEG are significantly related to the D-dimer and PAgT levels in patients with acute cerebral infarction. TEG plays a role in the diagnosis of acute cerebral infarction, evaluation of severity of acute cerebral infarction and monitoring of hypercoagulable state.

关 键 词：急性脑梗死 血栓弹力图 血小板聚集率 D-二聚体 

分 类 号：R743.33[医药卫生—神经病学与精神病学]