血栓弹力图对军队干部缺血性脑血管病预防及凝血功能评价影响研究  

Effect of thromboelastic diagram on prevention of ischemic cerebrovascular disease and evaluation of coagulation function in military cadres

作　　者：陈兵[1] 张玉峰 CHEN Bing;ZHANG Yu-feng(Department of Neurology,The Eighth Medical Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心神经内科

出　　处：《临床军医杂志》2019年第10期1149-1151,共3页Clinical Journal of Medical Officers

基　　金：保健专项科研课题任务书(15BJZ25)

摘　　要：目的探讨血栓弹力图对军队干部缺血性脑血管病预防和凝血功能评价的影响。方法将自2014年1月至2017年8月于解放军309医院体检的年龄>50岁的200例军队干部纳入A组,既往有脑梗死病史者为A1组(n=83),无脑梗死病史者为A2组(n=117);将同期地方医院体检的年龄>50岁的200例地方人员纳入B组,既往有脑梗死病史者为B1组(n=72),无脑梗死病史者为B2组(n=128);将同期于解放军309医院住院的396例急性脑梗死军队干部纳入C组。A、B两组均进行血栓弹力图相关指标检测;C组进行血栓弹力图相关指标检测及凝血四项、血小板检查。结果A1组、B1组、A2组、B2组4组的凝血反应时间、血细胞凝集块形成时间、凝固角、最大振幅两两比较,差异均无统计学意义(P>0.05)。凝血四项+血小板检出高凝状态者153例(38.6%),血栓弹力图检出193例(48.7%),血栓弹力图对高凝状态的检出率高于凝血四项+血小板,差异有统计学意义(P<0.05)。凝血反应时间与活化部分凝血活酶时间呈正相关(r=0.334,P<0.05);血细胞凝集块形成时间与活化部分凝血活酶时间呈正相关(r=0.168,P<0.05),与血小板、纤维蛋白原呈负相关(r=-0.323、-0.328,P<0.05);凝固角与血小板、纤维蛋白原呈正相关(r=0.309、0.325,P<0.05),与活化部分凝血活酶时间呈负相关(r=-0.171,P<0.05);最大振幅与血小板、纤维蛋白原呈正相关(r=0.399、0.427,P<0.05)。结论血栓弹力图不能单独反映高凝状态。在军队干部缺血性脑血管病凝血功能检测中,血栓弹力图的检出率高于凝血四项、血小板,可以弥补凝血四项、血小板检查的不足,有效评价机体凝血功能,发现凝血异常。Objective To investigate the effect of thromboelastic diagram on prevention of ischemic cerebrovascular disease and evaluation of coagulation function in military cadres.Methods From January 2014 to August 2017,200 military cadres over the age of 50 who had physical examination were included in Group A.The patients with a previous history of cerebral infarction were in Group A1(n=83),and the patients without cerebral infarction were in Group A2(n=117).The 200 local personnel over 50 years old who underwent physical examination in local hospitals at the same period were included in Group B.Patients with previous history of cerebral infarction were in Group B1(n=72),and patients without cerebral infarction were in Group B2(n=128).The 396 military cadres with acute cerebral infarction hospitalized during the same period were included in Group C.Both Groups A and B were tested for relevant indicators of thrombus elasticity diagram.In Group C,thromboembolic elastigram and clotting and platelet tests were performed.Results The pairwise comparison of coagulation reaction time,hemagglutination formation time,coagulation angle and maximum amplitude between Groups A1,B1,A2 and B2 showed no statistical significance(P>0.05).Hypercoagulability was detected in 153 patients(38.6%)and hypercoagulability was detected in 193 patients(48.7%).The detection rate of hypercoagulability was higher in thromboelastic diagram than in thrombotic thrombotic diagram(P<0.05).The time of coagulation reaction was positively correlated with the time of activated thrombin(r=0.334,P<0.05).The formation time of hemagglutination was positively correlated with the time of activated thrombin(r=0.168,P<0.05),and negatively correlated with platelet and fibrinogen(r=-0.323,-0.328,P<0.05).Coagulation Angle was positively correlated with platelet and fibrinogen(r=0.309,0.325,P<0.05),and negatively correlated with activated thrombin time(r=-0.171,P<0.05).The maximum amplitude was positively correlated with platelet and fibrinogen(r=0.399,0.427,P<0.05).Conclu

关 键 词：血栓弹力图 军队干部 缺血性脑血管病 凝血功能 

分 类 号：R446.11[医药卫生—诊断学]