血栓弹力图对急性弥散性血管内凝血诊断价值的研究  

Diagnostic Value of Thromboelastography for Acute Disseminated Intravascular Coagulation

作　　者：王影 阎妍[1] 王忠利[1] WANG Ying;YAN Yan;WANG Zhong-Li(Department of Laboratorian Medicine,The Second Hospital of Dalian Medical University,Dalian 116000,Liaoning Province,China)

机构地区：[1]大连医科大学附属第二医院检验科,辽宁大连116000

出　　处：《中国实验血液学杂志》2020年第5期1699-1703,共5页Journal of Experimental Hematology

摘　　要：目的:探讨血栓弹力图对急性弥散性血管内凝血(DIC)的诊断价值。方法:回顾性分析疑似DIC患者155例的临床资料、血常规指标检测数据、血凝指标检测数据及TEG检测数据,并采用ROC曲线对TEG检测数据进行诊断效能分析。结果:DIC组CDSS得分9.2±1.4分,显著高于非DIC组的4.2±1.1分(P<0.05)。DIC组患者PLT水平低于非DIC组(P<0.05),PT、APTT、INR、DD及FIB水平均明显高于非DIC组(P<0.05)。DIC组R时间、K时间及LY30均大于非DIC组(P<0.05),α角及MA值均小于非DIC组(P<0.05)。ROC曲线分析结果显示,R时间、K时间、α角、MA值及LY30最佳临界值分别为8.4 min、6.2 min、52.5°、43.2 mm及6.7%。组间总分≥1、总分≥2、总分≥3、总分≥4曲线下面积分别为0.552、0.650、0.687及0.613。结论:血栓弹力图对急性弥散性血管内凝血具有一定诊断价值。Objective:To investigate the diagnostic value of thromboelastography(TEG)for acute disseminated intravascular coagulation(DIC).Methods:The clinical data and data of blood routine indexes,blood coagulation indexes and TEG indexes of acute 155 DIC patients were collected and analyzed retrospectively.Results:The CDSS scores of DIC and non-DIC groups were 9.2±1.4 and 4.2±1.1 respectively,and the CDSS scores of DIC group was significantly higher than those in non-DIC group(P<0.05).The PLT level in DIC group was significantly lower than that in non-DIC group(P<0.05),the PT,APTT,INT,DD and FIB levels in DIC group were significantly higher than those in non-DIC group(P<0.05).The R time,K time and LY30 in DIC group were significantly higher than those in non-DIC group(P<0.05),and theαand MA in DIC group were significantly lower than those in non-DIC group(P<0.05).ROC curve analysis showed that the best cutoff value of R time,K time,α,MA and LY30 were 8.4 min,6.2 min,52.5°,43.2 mm and 6.7%respectively.The AUC of total scores≥1,≥2,≥3 and≥4 were 0.552,0.650,0.687 and 0.613 respectively.Conclusion:The TEG possesses the certain value in the diagnosing of DIC.

关 键 词：弥散性血管内凝血 血栓弹力图 ROC曲线 诊断价值 

分 类 号：R554.8[医药卫生—血液循环系统疾病]