颈动脉斑块特征联合血栓弹力图诊断斑块稳定性的应用效果分析  

Analysis of the Application Effect of Carotid Artery Plaque Characteristics Combined with Thrombelastogram on Diagnosing Plaque Stability

作　　者：穆斌[1] 郝芳芳 孟祥安[1] 黄淮[1] 曾小雁 胡金雅 孙志华[1] Mu Bin;Hao Fangfang;Meng Xiang an(CNPC Central Hospital,Langfang,Hebei 065000,China)

机构地区：[1]中国石油天然气集团公司中心医院神经内科超声医学科,河北廊坊065000

出　　处：《四川医学》2018年第11期1270-1273,共4页Sichuan Medical Journal

基　　金：河北省廊坊市科技支撑计划项目(编号:2017013147)

摘　　要：目的探讨颈动脉斑块特征联合血栓弹力图诊断斑块稳定性的应用效果。方法选取2017年6月至2018年6月在我院治疗的颈动脉硬化斑块患者97例,均进行血栓弹力图和颈动脉超声检查,同时检测凝血功能。结果97例患者中,稳定斑块52例,不稳定斑块45例;不稳定斑块组凝血反应时间(R)和血凝块形成时间(K)分别为(4. 61±1. 82) min和(1. 74±0. 62) min明显低于稳定斑块组,凝血块强度(G)和凝血综合指数(CI)分别为(9. 21±2. 06)和(0. 78±0. 32),明显高于稳定斑块组,差异均有统计学意义(P<0. 05)。不稳定斑块组活化部分促凝血酶原激酶时间(APTT)为(24. 10±2. 03) s明显低于稳定斑块组,而纤维蛋白原(FIB)和D-二聚体(D-D)分别为(3. 62±0. 53) g/L和(1. 17±0. 34) g/L,明显高于稳定斑块组,差异均有统计学意义(P<0. 05); R值与FIB呈负相关(r=-0. 681,P<0. 05),K值与APTT呈正相关(r=0. 859,P<0. 05)。结论血栓弹力图参数R、K、G和CI与颈动脉斑块特征有一定关系,同时R和K与患者凝血功能有关。Objective To investigate the application effect of carotid artery plaque characteristics combined with thrombelastogram on diagnosing plaque stability.Methods A total of 97 patients with carotid atherosclerotic plaques who were treated in our hospital from June 2017 to June 2018 were selected and examined by thrombelastogram and carotid ultrasonography,and the coagulation function was also tested.Results Among the 97 patients,52 had stable plaques and 45 had unstable plaques; the coagulation reaction time( R) and coagulation formation time( K) of the unstable plaque group were( 4. 61±1. 82) min and( 1. 74±0. 62)min,significantly lower than those of the stable plaque group,clot intensity( G) and coagulation complex index( CI) were( 9. 21 ±2. 06) and( 0. 78±0. 32),significantly higher than those of the stable plaque group,and the differences were statistically significant( P<0. 05).activated partial thromboplastin time( APTT) of the unstable plaque group was( 24. 10±2. 03) s,significantly lower than that of the stable plaque group,while fibrinogen( FIB) and d-dimer( D-D) were( 3. 62 ± 0. 53) g/L and( 1. 17 ± 0. 34) g/L,significantly higher than those of the stable plaque group,with statistically significant differences( P<0. 05); R value was negatively correlated with FIB( r =-0. 681,P<0. 05),and K value was positively correlated with APTT( r = 0. 859,P<0. 05). Conclusion The parameters R,K,G and CI of the thrombelastogram are related to the characteristics of carotid artery plaques,and R and K are related to the coagulation function of the patients.

关 键 词：血栓弹力图 凝血功能 稳定斑块 不稳定斑块 颈动脉斑块 

分 类 号：R543.4[医药卫生—心血管疾病]