血栓弹力图和比浊法检测脑肿瘤患者血小板聚集功能的对比研究  

Performance evaluation of thromboelastogram(TEG)and light transmission aggregometry(LTA)in measuring platelet aggregation of patients with brain tumor:a comparative study

作　　者：霍姿含[1] 郭莹莹 刘冰[1] HUO Zihan;GUO Yingying;LIU Bing(Department of Blood Transfusion,The First Bethune Hospital of Jilin University,Changchun 130021,China)

机构地区：[1]吉林大学第一医院输血科,吉林长春130021

出　　处：《中国输血杂志》2020年第7期676-678,共3页Chinese Journal of Blood Transfusion

摘　　要：目的分析比较血栓弹力图(TEG)与比浊法(LTA)在脑肿瘤患者血小板聚集功能检测中的相关程度和对出血事件的敏感性。方法收集2019年1—5月期间神经肿瘤科脑肿瘤手术患者84例,对血栓弹力图的MA值与ADP诱导的光学比浊法血小板聚集率检测进行相关性分析,并比较这2种方法检测结果与出血事件发生率的关系。结果 MA值与血小板计数有相关性(r=0.344 2,P<0.05),MA值与ADP诱导的血小板聚集率具有相关性(r=0.268 8,P<0.05),血小板计数与ADP诱导的血小板聚集率具有相关性(r=0.261 4,P<0.05)。预测出血事件敏感性方面,采用TEG法检测出MA值<60的患者16例(19%,16/84),LTA法检测出血小板聚集率<55%的患者31例(36.9%,31/84)(χ~2=8.333,P<0.05)。MA值对输注量的ROC曲线,cutoff=65.5,曲线下面积0.599 3,P>0.05。ADP对输注量ROC曲线cutoff=52.2,曲线下面积0.728 1,P<0.05。结论 TEG与比浊法在检测血小板聚集功能方面各有优势,也有其自身的局限性。TEG作为1种准确性较高的血小板功能即时检测方法,更适用于急诊手术等需要紧急检测血小板功能的情况。Objective To analyze the correlation between thromboelastogram(TEG)and light transmission aggregometry(LTA)in measuring platelet aggregation of patients with brain tumor,and to exam the sensitivity in operative and postoprative bleeding.Methods A total of 84 patients who underwent brain tumor surgery between January to May 2019 were recruited.The consistency and correlation between MA on TEG and ADP-induced platelet aggregation rate by LTA were analyzed,and the relationship between the risk of bleeding and the results by two methods was examined.Results MA value on TEG was significantly correlated with platelet count(r=0.3442,P<0.05)and ADP induced platelet aggregation rate(r=0.2688,P<0.05);platelet count was significantly correlated with ADP induced platelet aggregation rate(r=0.2614,P<0.05).In terms of predicting bleeding,MA value<60 was detected by TEG in 16 cases(19%,16/84),and the platelet aggregation rate<55%by LTA in 31 cases(36.9%,31/84)(χ~2=8.333,P<0.05).ROC curve of MA value vs infusion volume demonstrated cutoff=65.5,AUC=0.5993.ROC curve of ADP vs infusion volume demonstrated AUC=0.7281,cutoff=52.2(P<0.05).Conclusion TGE and LTA showed respective good consistency and limitations in monitoring the platelet function.TEG,as a highly accurate instant detection method,is more suitable for measuring platelet aggregation in emergency.

关 键 词：血栓弹力图法 光学比浊法 血小板聚集功能 

分 类 号：R457.1[医药卫生—治疗学] R739.41[医药卫生—临床医学]