血浆血栓弹力图与抗凝血酶Ⅲ检测对儿童川崎病诊断的应用价值  

Correlation Discussion of Blood Plasma Thromboelastography Values and Antithrombin Ⅲ Level in Children's Kawasaki Disease

作　　者：靳剑芸[1] 李启亮[1] 宋文琪[1] 

机构地区：[1]首都医科大学附属北京儿童医院检验中心,北京100045

出　　处：《现代检验医学杂志》2017年第5期130-132,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血栓弹力图(TEG)水平与抗凝血酶Ⅲ(ATⅢ)对儿童川崎病(kawasaki disease,KD)的诊断应用价值。方法选取2015年1月～2017年2月北京儿童医院60例住院KD患儿(KD组)与42例正常对照(健康组)。同期依据心超结果选取28例有冠脉病变组(CAL组)和30例未伴冠脉病变组(NCAL组)。检测各组TEG参数(用血栓弹力仪测定),包括凝血反应时间(R)、血细胞凝集成块时间(K)、血细胞凝集成块速率(α角)、凝血块的最大强度(MA)、凝血综合指数(CI)和ATⅢ活性(凝血分析仪检测)。结果 KD组的K 1.11±0.36 min,ATⅢ90.5%±19.05%和R 5.40±1.72 min低于健康组(2.29±0.66 min,110.4%±10.8%和6.85±2.32 min),差异有统计学意义(t=-6.483,-4.267,-3.205,均P<0.05);KD组的CI 2.11±0.70,α角75.23°±6.97°和MA 67.08±6.27 mm高于健康组(1.90±0.40,69.65°±5.28°和59.12±3.52 mm),差异有统计学意义(t=2.339,3.235,4.265,均P<0.05);CAL组的ATⅢ75.5%±9.70%,R4.40±1.27 min和K 1.03±0.30 min低于NCAL组(95.6%±12.8%,5.73±1.26 min和1.21±0.16 min),差异有统计学意义(t=-5.382,-2.731,-2.483,均P<0.05);CAL组的MA 70.54±5.17mm,CI2.76±0.38和α角78.79°±2.56°)高于NCAL组(64.37±4.20 mm,2.10±0.49和74.43°±3.03°),差异有统计学意义(t=3.286,4.369,4.759,均P<0.05);CAL组ATⅢ与TEG参数R,K值之间呈正相关(r=0.495,0.793,P<0.05);与TEG参数α角,MA,CI值之间呈负相关(r=-0.422,-0.244,-0.236,均P<0.05)。结论 TEG水平与ATⅢ活性对儿童KD的诊断具有较好的应用价值,联合起来应用可作为一项实验室辅助诊断指标在临床推广。Objective To analyze and discuss the correlations of blood plasma thromboelastography （TEG） values and an- tithrombin III （ATIII） level in children＇s Kawasaki disease （KD）. Methods Selected 60 children＇s KD cases as well as 42 control cases as the KD group,28 children＇s KD cases with coronary arterial lesions （CAL） as well as30 children＇s KD cases without coronary arterial lesions （NCAL） as the CAL group. All eases were arehived from January 2015 to February 2017 in Beijing Children＇ s Hospital. The blood plasma TEG parameters were detected by thromboelastography, including blood coagulation time （R）, blood clotting time （K）, rate of blood clotting （（~ angle）, the maximum intensity of blood clotting （MA） ,coagulation comprehensive index （CI） and plasma ATIII level（detected by blood aggregation tester）. Results The K （11.1-0.36 min）,ATIII （90.5%±19.05%） and R （5.4±1.72 min） values were less than those in the control group （2.29±0.66 min,110.4%±10.8% and 6.85±2.32 rain,t=-6. 483,-4. 267,-3. 205,ali P〈0.05）. CI （2.11±0.70） ,α angle （75.23°±6.97°） and MA （67. 08±6.27 rnm） values in the KD group were higher than those in the control group （1. 90±0. 40,69. 65°±5. 28° and 59.12±3.52 mm,t=2.339,3.235,4.265,aU P〈0.05）.InCAL group,ATIH （75.5± 9.70%）,R （4.40±1.27 min） and K （1.03±0.30 min） values were less than those in the NCAL group （95.6%±12.8%）, 5.73±1.26 min,l. 21±0.16 min, t= - 5. 382, - 2. 731, - 2. 483, all P〈0.05）. MA （70.54±5.17 mm）,CI （2.76±0.38） ,and a angle （78.79°±2.56°） values in CAL group werehigher than NCAL group （64.37±4.20 mm,2.10±0.49 and 74.43°±3.03°,t=3. 286,4. 369,4. 759,all P〈0.05）. In CAL group,it showed that ATI]I level was positive correlated with R and K values （r=0. 495,0. 793,P〈0.05） but negative correlated with a angle,MA and CI values （r=-0. 422,-0. 244 and -0. 236,P〈0.05）. Conclusion Blood plasma TEG values and ATⅢ le

关 键 词：川崎病 血栓弹力图 抗凝血酶Ⅲ 相关性 

分 类 号：R593.2[医药卫生—内科学] R446.111[医药卫生—临床医学]