肺动脉血栓栓塞患者检测血栓弹力图、D-二聚体及纤维蛋白原的相关性  

Correlation between Thromboelastography,D-dimer and Fibrinogen in Patients with Pulmonary Thromboembolism

作　　者：任朝凤[1] 刘芬 杨丽芬[1] 吴涛[1] 赵娅琳 REN Chao-feng;LIU Fen;YANG Li-fen;WU Tao;ZHAO Ya-lin(Dept.of Respiratory and Critical Care Medicine,The First People’s Hospital of Kunming,Kunming Yunnan 650011,China)

机构地区：[1]昆明市第一人民医院呼吸与危重症医学科,云南昆明650011

出　　处：《昆明医科大学学报》2020年第2期96-99,共4页Journal of Kunming Medical University

基　　金：昆明市卫生和计划生育委员会科研项目(2018-03-02-002)。

摘　　要：目的探讨肺动脉血栓栓塞患者联合检测血栓弹力图(TEG)、D-二聚体(D-D)及纤维蛋白原(FIB)间的相关性。方法选取自2018年5月至2019年5月住昆明市第一人民医院呼吸与危重症医学科确诊为肺血栓栓塞症的40例患者为研究组,无肺血栓栓塞的45例患者为对照组,应用CFMS血栓弹力图检测仪和STAR全自动凝血分析仪分别检测血栓弹力图(K值、R值、α角、MA值)和D-二聚体、纤维蛋白原等指标。结果肺血栓栓塞组α角、MA值、FIB、D-D水平均明显高于对照组(P<0.001);而K值及R值则明显低于对照组(P<0.001)。将两组数据合并分析,结果发现FIB与MA正相关,rs=0.388,P=0.015。FIB与α角正相关,rs=0.393,P=0.013。DD与K、R、MA和α角均有相关关系(P<0.05)。DD与K负相关,rs=-0.655,P<0.001。DD与R负相关,rs=-0.715,P<0.001。DD与MA正相关,rs=0.603,P<0.001。DD与α角正相关,rs=0.764,P<0.001。结论肺血栓栓塞症的发生、发展与D-D、FIB水平呈正相关;而D-D、FIB与α角、MA值呈正相关;D-D与K值、R值呈负相关;所以TEG检测对肺动脉血栓栓塞是一种有实用价值的筛选试验,可以为临床诊断肺血栓栓塞提供有效的依据。Objective To investigate the association between thromboelastography(TEG),D-dimer(DD)and fibrinogen(FIB)in patients with pulmonary thromboembolism.Methods Forty patients diagnosed with pulmonary thromboembolism in our department from May 2018 to May 2019 were enrolled in the study group.Forty-five patients without pulmonary thromboembolism were used as control group.CFMS thromboelastography was used.The STAR automatic coagulation analyzer was used to detect thromboelastograms(K value,R value,αangle,MA value)and D-dimer,fibrinogen and other indicators.Results The levels ofα,MA,FIB and DD in the pulmonary thromboembolism group were significantly higher than those in the control group(P<0.001).The K value and R value were significantly lower than those in the control group(P<0.001).The data in the two groups was combined and analyzed.It was found that FIB was positively correlated with MA,rs=0.388,P=0.015.FIB was positively correlated with the angleα,rs=0.393,P=0.013.DD was correlated with K,R,MA andαangles(P<0.05).DD was negatively correlated with K,rs=-0.655,P<0.001.DD was negatively correlated with R,rs=-0.715,P<0.001.DD was positively correlated with MA,rs=0.603,P<0.001.DD was positively correlated with the angle a,rs=0.764,P<0.001.Conclusion The occurrence and development of pulmonary thromboembolism is positively correlated with DD and FIB levels.DD and FIB are positively correlated withαangle and MA value.DD is negatively correlated with K value and R value.Therefore,TEG detection is a pulmonary thromboembolism.A practical screening test can provide an effective basis for clinical diagnosis of pulmonary thromboembolism.

关 键 词：肺动脉血栓栓塞 血栓弹力图 D-二聚体 纤维蛋白原 

分 类 号：R563.5[医药卫生—呼吸系统]