血栓弹力图与凝血四项、血小板计数在评估输血患者凝血功能上的一致性分析  

Comparative analysis of thromboelastography and four items of coagulation and platelet count in evaluating coagulation function of patients with blood transfusion

作　　者：徐亚敏 梁晓浏 XU Yamin;LIANG Xiaoliu(Department of Blood Transfusion,Hefei First People’s Hospital,Anhui Province,Hefei 230601,China)

机构地区：[1]安徽省合肥市第一人民医院输血科,安徽合肥230601

出　　处：《中国医药导报》2021年第19期106-109,117,共5页China Medical Herald

摘　　要：目的探究血栓弹力图(TEG)与凝血四项、血小板计数在评估输血患者凝血功能上的一致性。方法选取2020年1月至7月在安徽省合肥市第一人民集团医院住院180例患者作为研究对象,按照最终是否进行输血治疗分为输血组(19例)和非输血组(161例)。两组均采集3份静脉血样本分别进行TEG、凝血四项和血小板计数检测。采用Kappa系数对TEG各参数与凝血四项及血小板计数进行一致性分析。结果输血组的凝血因子激活时间、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均长于非输血组,血块形成速率参数高于非输血组,弹力图最大切角及最大振幅、纤维蛋白原水平、血小板计数均低于非输血组,差异均有统计学意义(均P <0.05)。凝血因子激活时间与APTT在判断是否为低凝上有高度一致性(Kappa> 0.6,P <0.05);血块形成速率参数、弹力图最大切角(Kappa=0.199)及最大振幅与纤维蛋白原在判断是否为低凝上有一致性,但一致性较弱(均Kappa <0.4,P <0.05)。血块形成速率参数、弹力图最大切角及最大振幅与血小板计数在判断是否为低凝上有一致性,但一致性较弱(均Kappa <0.4,P <0.05)。结论除凝血因子激活时间与APTT在判断是否为低凝上有高度一致性外,TEG参数与凝血四项、血小板计数在判断是否为低凝上的一致性较弱。TEG参数与凝血四项及血小板计数检测各有侧重点,不能相互取代,临床上应结合患者的实际情况选择检测方法指导输血。Objective To explore the consistency of thromboelastography(TEG)and four items of coagulation and platelet count in evaluating coagulation function of patients with blood transfusion.Methods A total of 180 hospitalized patients in Hefei First People’s Group Hospital,Anhui Province from January to July 2020 were selected as the research subjects,and they were divided into the blood transfusion group(19 cases)and the non-blood transfusion group(161 cases)according to whether they received blood transfusion treatment.Three venous blood samples were collected from both groups for TEG,four items of coagulation and platelet count detection,respectively.Kappa consistency analysis was used to analyze the consistency between all parameters of TEG,four items of coagulation and platelet count.Results The coagulation factor activation time,prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)in the blood transfusion group were longer than those in the non-blood transfusion group,and the blood clot formation rate parameter was higher than that in the non-blood transfusion group,and the maximum cut angle and maximum amplitude of thromboelastography,fibrinogen level and platelet count were lower than those of non-transfusion group,with statistical significance(all P<0.05).The coagulation factor activation time was highly consistent with that of APTT in determining whether the coagulation was low(Kappa>0.6,P<0.05).The blood clot formation rate parameters,the maximum cut angle of thromboelastography and the maximum amplitude of thromboelastography were consistent with fibrinogen in determining whether there was low coagulation,but the consistency was weak(all Kappa<0.4,P<0.05).The blood clot formation rate parameters,the maximum cut angle of thromboelastography and the maximum amplitude of thromboelastography were consistent with platelet count in determining whether there was low coagulation,but the consistency was weak(all Kappa<0.4,P<0.05).Conclusion In addition to the high consistency between

关 键 词：凝血功能 血栓弹力图 凝血四项 血小板计数 输血 一致性 

分 类 号：R446.1[医药卫生—诊断学]