北京地区老年人血栓弹力图检测参考范围研究  

Establishment of normal reference values for thromboelastography in Chinese elderly in Beijing

作　　者：陆学军[1] 吴巍[1] 李传保[1] 赵昕[1] 

机构地区：[1]北京医院检验科国家老年医学中心,100730

出　　处：《中华老年医学杂志》2016年第9期986-989,共4页Chinese Journal of Geriatrics

摘　　要：目的测定北京地区65岁以上健康老年人血栓弹力图（TEG）数据，建立正常参考值，并与试剂厂家提供的正常参考值以及55岁以下对照组进行比较。方法2014年3～5月采集65岁以上健康老年人静脉血4ml，分别测定凝血四项和TEG。应用Haemoscope5000分别测定凝血反应时间（R）、凝血形成时间（K）、凝固角（α-Angle）、最大振幅（MA）检测TEG。凝血四项检测包括：凝血酶原时间（PT）、激活部分凝血致活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（FIB）。结果119例健康老年人TEG各参数平均值分别为R：6．29min，K：1．63min，α-Angle：66．09°，MA：63．43mm；各参数95％可信区间分别为R：4．4～8．2min，K：0．8～2．5min，α-Angle：55．0～77．1°，MA：54．5～72．3mm。老年组与对照组R值、K值和α-Angle均差异有统计学意义（P〈0．001或P〈0．05），老年人不同性别间在K值、α-Angle和MA值均差异有统计学意义（P〈0．05或P〈0．01）。16．1％（19例）的健康老年人至少有一项结果超出厂家提供的正常值范围，3％（3例）的健康老年人被诊断为凝血异常，检测特异度为84％。与厂家提供的参考范围比较，北京地区健康老年人的R值偏低，MA值偏高。结论血栓弹力图检测实验室需根据人群特点制定相应的参考范围。Objective To determine the normal reference values for thromboelastography （TEG） in Chinese healthy elderly people in Beijing and compare them with those provided by the manufacturer and with people under the age of 55 years. Methods The healthy elderly people aged over 65 years were enrolled from March 2014 to April 2014. 4 ml of peripheral vein blood samples were taken from each person. All subjects underwent the laboratory tests of prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT） and fibrinogen （FIB）. TEG parameters including reaction time （R）, coagulation time （K）, angle （alpha） and maximum amplitude （MA） were determined by using a Heamoscope 5000 device. Results A total of 119 healthy elderly subjects were enrolled in this study. The mean values （95 % CI） of TEG parameters for them were R： 6.29 min （4.48.2 min）, K： 1.63 min （0.8-2.5 min）, α-Angle.. 66.09° （55.0-77.1°）, MA： 63.43mm （54.5-72.3 mm）. There were significant differences in the values of R, K and α-Angle between the elderly and non-elderly groups （P〈0. 001 or 0.05）. There were significant differences in the values of K, α-Angle and MA between males and females （P〈0.05 or 0. 001）. According to the normal reference values provided by the manufacturer, 16.1% （19/119） of the healthy elderly volunteers had at least one abnormal parameter beyond its normal range. 3% （3/119） of the healthy elderly people were diagnosed as coagulation abnormalities, yielding a specificity of 84%. Compared with normal reference values provided by the manufacturer, the value of R was lower and the value of MA was higher in the healthy elderly people in Beijing. Conclusions The normal reference values for TEG should be established based on the local population characteristics.

关 键 词：血栓弹力描记术 参考值 

分 类 号：R446.11[医药卫生—诊断学]