血栓弹力图联合凝血指标对早产儿凝血功能的评估价值  

Evaluation value of thromboelastography combined with coagulation index on coagulation function of premature infants

作　　者：罗素云[1] 何成龙[1] 陈钊毅[1] 王琴[2] 许春华[1] LUO Su-yun;HE Cheng-long;CHEN Zhao-yi;WANG Qin;XU Chun-hua(Department of Neonatology,the Houjie Hospital of Dongguan City,Dongguan 523945,Guangdong,CHINA;Department of Neonatology,Sun Yat-sen Memorial Hospital Affiliated to Sun Yat-sen University,Guangzhou 510120,Guangdong,CHINA)

机构地区：[1]东莞市厚街医院新生儿科,广东东莞523945 [2]中山大学附属孙逸仙纪念医院新生儿科,广东广州510120

出　　处：《海南医学》2020年第16期2089-2092,共4页Hainan Medical Journal

基　　金：2018年广东省东莞市科技发展(一般)项目立项(编号:2018507150231369)。

摘　　要：目的探究血栓弹力图联合凝血指标对早产儿凝血功能的评估效果。方法选取2017年6月至2019年6月期间在东莞市厚街医院及中山大学附属孙逸仙纪念医院分娩的110例单胎新生儿为研究对象,将其中50例早产儿(胎龄<37周)设为早产组,其余60例足月儿(胎龄≥37周)设为足月组。并依据常规凝血功能检查将新生儿分为观察组(凝血功能异常,48例)和对照组(凝血功能正常,62例)。所有新生儿均进行常规凝血功能检查及血栓弹力图检查,分别对早产组与足月组新生儿、观察组与对照组新生儿的血浆凝血功能指标及血栓弹力图相关凝血功能指标进行比较,并对上述各指标与早产儿凝血功能的相关性行Spearman相关分析。结果早产组新生儿的血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)水平明显高于足月组新生儿,血浆纤维蛋白原(FIB)水平明显低于足月组新生儿,差异有统计学意义(P<0.05)。早产组新生儿与足月组新生儿的血细胞凝集块形成速率(α角)比较差异无统计学意义(P>0.05)。早产组新生儿的凝血反应时间(R)、血块形成时间(K)、血凝块最大强度(MA)、纤活指数(EPL)、凝血幅度下降速率(LY30)水平高于足月组新生儿,凝血综合指数(CI)值低于足月组新生儿,差异有统计学意义(P<0.05)。观察组新生儿的血浆PT、APTT、TT水平高于对照组新生儿,血浆FIB水平低于对照组新生儿,差异有统计学意义(P<0.05)。观察组新生儿与对照组新生儿的α角比较差异无统计学意义(P>0.05)。观察组新生儿的R、K、MA、EPL、LY30水平高于对照组新生儿,CI值低于对照组新生儿,差异有统计学意义(P<0.05)。血浆PT、APTT、TT水平、R、K、MA、EPL、LY30水平与早产儿凝血功能均呈正相关(P<0.05),血浆FIB、CI值与早产儿凝血功能呈负相关(P<0.05)。结论血栓弹力图与血浆凝血指标对早产儿凝血功能均有一定的�Objective To investigate the evaluation effect of thromboelastography(TEG)combined with coagulation index on coagulation function of premature infants.Methods A total of 110 single-birth neonates born in Houjie Hospital of Dongguan City and Sun Yat-sen Memorial Hospital Affiliated to Sun Yat-sen University from June 2017 to June 2019 were selected as the research object,and 50 of them born prematurely(gestational age<37 weeks)were set as preterm group,the remaining 60 full-term children(gestational age≥37 weeks)were set as full-term group.And according to the routine coagulation test,the newborns were divided into the observation group(abnormal coagulation function,n=48)and the control group(normal coagulation function,n=62).All neonates undergo routine coagulation function examination and thrombus elasticity examination,and the plasma coagulation function indexes and thrombus elasticity chart-related coagulation function indexes of neonates in the preterm and full-term groups,as well as the observation group and the control group were compared.Spearman correlation analysis was performed on the correlation between the above indexes and the coagulation function of premature infants.Results The levels of plasma prothrombin time(PT),activated partial prothrombin time(APTT),and thrombin time(TT)in the preterm group were significantly higher than those in the full-term group,while the plasma fibrinogen(FIB)level was significantly lower than that in the full-term group(all P<0.05).There was no statistically significant difference in the rate of hemagglutination(αangle)between the preterm group and the term group(P>0.05).The coagulation reaction time(R),clot formation time(K),blood clot maximum intensity(MA),fibrillation index(EPL),and rate of decrease in coagulation amplitude(LY30)in the preterm group were significantly higher than those in the full-term group,while the coagulation comprehensive index(CI)value was significantly lower than that of full-term neonates(all P<0.05).Plasma PT,APTT and TT levels in the obs

关 键 词：早产 凝血功能 凝血指标 血栓弹力图 评估 

分 类 号：R722[医药卫生—儿科]