蜂蜇伤患者血栓弹力图与常规凝血检测的相关性分析  

Correlations between thromboelastogrphy and conventional coagulation test in patients with wasp sting

作　　者：谢明欣 曹小平[1] 于任轩 张悦 王思懿 胡青 XIE Ming-xin;CAO Xiao-ping;YU Ren-xuan;ZHANG Yue;WANG Si-yi;HU Qing(Department of Emergency,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]川北医学院附属医院急诊医学科,四川南充637000

出　　处：《川北医学院学报》2021年第3期329-332,共4页Journal of North Sichuan Medical College

基　　金：四川省卫生和计划生育委员会科研课题(17ZD016)。

摘　　要：目的:评价蜂蜇伤患者凝血功能并分析蜂蜇伤患者血栓弹力图(TEG)与常规凝血检测结果的相关性。方法:回顾性分析41例蜂蜇伤患者的临床资料,统计常规凝血参数(PT、APTT、FIB、P-FDP、D-D)及TEG参数(R、K、α、MA、CI)的异常率,分析常规凝血参数值与TEG参数值的相关性,分析存在显著相关性参数的一致性,并作受试者工作特征(ROC)曲线描述。结果:常规凝血检验参数异常率为12.1%~61%,其中APTT异常率最高;TEG参数异常率为24.4%~46.3%,CI值异常率最高。相关性分析显示,R值与PT、APTT值呈正相关,与P-FDP、D-D值呈负相关;K值与APTT值呈正相关,与P-FDP、D-D值呈负相关;α值与P-FDP、D-D值呈正相关,与APTT值呈负相关;MA值与D-D呈正相关,与APTT值呈负相关;CI值与D-D值呈正相关,与PT、APTT值呈负相关;CI值与APTT值相关(r=0.713,P<0.001)。一致性分析显示,CI与APTT的Kappa值为0.713,具有较高的检验一致性。ROC曲线显示,APTT值预测CI<-3的敏感性为100%,特异性为79.17%。结论:蜂蜇伤患者凝血功能异常发生率较高,出血风险较大;TEG与常规凝血参数具有一定相关性;APTT值与CI值具有检测一致性,检验结果可相互参考。Objective:To investigate the coagulation state of wasp sting patients and to investigate the correlations between thrombelastography(TEG)and conventional coagulation test.Methods:41 patients with wasp stings were retrospectively analyzed.The abnormal rates of routine coagulation parameters(PT,APTT,FIB,P-FDP,D-D)and TEG parameters(R,K,α,Ma,CI)were analyzed.The correlation between routine coagulation parameters and TEG parameters was analyzed.The consistency of parameters with significant correlation was analyzed,and the receiver operating characteristic(ROC)curve was performed.Results:Abnormal rate of conventional coagulation test parameters was 12.1%~61%,among which APTT was the highest.The abnormal rate of TEG parameter was 24.4%~46.3%,and the abnormal rate of CI value was the highest.Correlation analysis showed that the R value of TEG parameter was positively correlated with the PT and APTT values of routine blood coagulation detection parameters,but negatively correlated with P-FDP and D-D values.K value was positively correlated with APTT value,but negatively correlated with P-FDP and D-D value.αvalue was positively correlated with P-FDP and D-D value,and negatively correlated with APTT value.MA value was positively correlated with D-D and negatively correlated with APTT value.CI value was positively correlated with D-D value,and negatively correlated with PT and APTT value.The CI value of TEG was significantly correlated with the APTT value of conventional coagulation test(r=0.713,P<0.001).The CI and APTT Kappa values were 0.713,showing a high degree of test consistency.ROC curve showed that the sensitivity and specificity of APTT predicting CI<-3 were 100%and 79.17%,respectively.Conclusion:Patients with wasp stings have a higher incidence of coagulation dysfunction and a higher risk of bleeding.TEG has a certain correlation with the parameters of conventional coagulation test.The APTT of conventional coagulation test and the CI values of TEG are consistent,and the test results can be used for mutual refer

关 键 词：蜂蜇伤 血栓弹力图 常规凝血检测 相关性 

分 类 号：R459.7[医药卫生—急诊医学]