血栓弹力图参数与血浆狼疮抗凝物质相关性探讨  

Correlation between Lupus Anticoagulant in Plasma and the Parameters of Thromboelastography

作　　者：沈韻[1] 刘禹 梁茜[1] 许冠群[1] SHEN Yun;LIU Yu;LIANG Qian;XU Guan qun(Department of Laboratory Medicine,Ruijin Hospital of Medical College,Shanghai J iaotong University,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院检验科,上海200025

出　　处：《现代检验医学杂志》2018年第5期8-11,共4页Journal of Modern Laboratory Medicine

基　　金：国家自然科学基金(81400100;81401726)

摘　　要：目的评估血栓弹力图(TEG)各参数与血浆狼疮抗凝物质(LAC)的相关性。方法收集2012年1月～2018年3月瑞金医院收治的LAC阳性患者56例以及健康对照组40例,同时进行LAC,活化部分凝血活酶时间(APTT)以及TEG检测。采用one-way ANOVA检验分析各组间APTT,TEG反应时间(R值),MA值,凝血综合参数(CI值)的差异,采用Spearman轶相关检验分析LAC与APTT,TEG各参数的相关性。结果各组间APTT,TEG R值和CI值的差异均有统计学意义(F=40.70,13.52,9.185,均P<0.000 1),各组间TEG MA值的差异无统计学意义(F=0.967 3,P=0.424 7)。LAC阳性患者组的APTT和TEG R值显著高于正常对照组,CI值显著低于正常对照组(均P<0.000 1)。LAC与APTT及TEG R值间存在正相关,相关系数分别为0.791 8(P<0.000 1)和0.712 3(P<0.000 1)。LAC与TEG MA值和CI值间为负相关,相关系数分别为-0.247 9(P=0.014 9)和-0.636 0(P<0.000 1)。结论虽然TEG参数与LAC存在相关性,但其临床意义与患者体内的高凝状态不符。Objective To evaluate the correlation between lupus anticoagulant （LAC） and thromboelastography （TEG） pa rameters. Methods A total of 56 patients with positive LAC and 40 normal individual were enrolled. Activated partial thromboplastin time （APTT） ,LAC and TEG analysis was performed in each patient. Three TEG parameters were Toni tored,including reaction time （R） to clot initiation, maximum vertical amplitude （MA） and coagulation index （CI）. Differ ences between groups were analyzed by one way ANOVA. The correlation between LAC and each parameter were evaluated by Spearman correlation test. Results There was significant difference between each group for APTT, R and CI （F value was 40.70,13.52 and 9. 185, P〈0. 000 1） respectively, while no significant difference was observed for MA （F=0. 967 3, P =0. 424 7）. APTT and R were significantly higher in patients with positive LAC, while CI was significantly lower in pa dents with positive LAC （P〈0. 000 1）. There was positive correlation between LAC and APTT/R, and the coefficient of correlation was 0. 791 8 （P〈0. 000 1） and 0. 712 3 （P〈0. 000 1）, respectively. There was negative correlation between LAC and MA/CI,and the coefficient of correlation was 0. 247 9 （P=0. 014 9） and 0. 636 0 （P〈0. 0001） ,respectively. Conehlsion Although significant correlation was observed between LAC and TEG parameters, the TEG results did not re flect the hypercoagulable state in vivo for patients with positive LAC.

关 键 词：狼疮抗凝物质 血栓弹力图 活化部分凝血活酶时间 

分 类 号：R446.11[医药卫生—诊断学]