血栓弹力图与传统凝血试验对肝病凝血功能评价的相关性研究  

Simultaneous interpreting of thrombus elastograph and traditional coagulation test in evaluating coagulation function of liver disease

作　　者：郑洁莹[1] 罗文波 吴为强[1] Zheng Jieying;Luo Wenbo;Wu Weiqiang(The Traditional Chinese Medicine Hospital of Zhongshan City Zhongshan,Guangdong528400)

机构地区：[1]中山市中医院,广东中山528400

出　　处：《基层医学论坛》2021年第25期3658-3660,共3页The Medical Forum

基　　金：中山市医学科研项目(2020A020325)。

摘　　要：目的分析传统凝血试验、血栓弹力图(TEG)对肝病凝血功能评价的相关性。方法选取2019年9月—2020年8月收治的90例肝病住院患者,根据疾病类型分为4组,慢性肝炎组(30例)、肝硬化代偿组(27例)、肝硬化失代偿组(19例)、慢性肝衰竭组(14例),所有患者接受TEG与传统凝血试验,并分析患者凝血试验、TEG与凝血功能的相关性。结果与慢性肝炎组患者对比,肝硬化代偿组患者TEG指标R、K升高,a角下降(P<0.05),凝血试验指标PT、APTT升高,FIB下降(P<0.05)。肝硬化失代偿组TEG指标R、K升高、a角下降,凝血试验指标PT、APTT升高,FIB下降,与肝硬化代偿组对比(P<0.01);慢性肝衰竭组患者TEG指标R、K显著升高、a角显著下降,凝血试验指标PT、APTT显著升高,FIB显著下降,与肝硬化失代偿组对比(P<0.01)。肝病患者TEG指标中a角与凝血指标PT呈负相关,与凝血指标FIB呈正相关(P<0.01);而TEG指标中R值与凝血指标APTT、PT呈正相关性(P<0.05),K值与凝血指标FIB呈负相关(P<0.05)。肝病患者TEG指标中R值与凝血酶FIB无相关性,a角与APTT无相关性,K值与凝血酶PT、APTT指标不存在相关性。结论肝病患者凝血功能指标与血栓弹力图指标存在密切相关性,可通过检测TEG指标参数,评价患者凝血功能紊乱情况。Objective To analyze the correlation between traditional coagulation test and thromboelastography(TEG)in evaluating coagulation function of liver diseases.Methods 90 hospitalized patients with liver disease from September 2019 to August 2020 were selected and divided into four groups according to the type of disease:chronic hepatitis group(30 cases),liver cirrhosis compensation group(27 cases),liver cirrhosis decompensation group(19 cases)and chronic liver failure group(14 cases).All patients received TEG and traditional coagulation test,and the coagulation test and TEG were analyzed It is related to coagulation function.Results compared with patients with chronic hepatitis,R and K of TEG increased and a angle decreased in patients with compensated cirrhosis(P<0.05).Pt and APTT increased,FIB decreased(P<0.05).TEG index in decompensated cirrhosis group R.K increased,a angle decreased,Pt,APTT increased,FIB decreased,compared with cirrhosis compensation group(P<0.05).In chronic liver failure group,TEG index R and K increased significantly,a angle decreased significantly,and coagulation test index decreased significantly.Pt and APTT increased significantly,FIB decreased significantly,compared with decompensated cirrhosis group(P<0.01).According to the analysis,a-angle in TEG index of liver disease patients was negatively correlated with Pt,and positively correlated with FIB(P<0.01);R value in TEG index was positively correlated with APTT and Pt(P<0.05)and K value was negatively correlated with FIB(P<0.05).There was no correlation between R value and thrombin FIB,a angle and APTT,and K value and thrombin Pt,APTT.Conclusion There is a close correlation between coagulation function indexes and thromboelastography indexes in patients with liver disease.We can evaluate coagulation disorder by detecting TEG index parameters.

关 键 词：肝病 凝血功能 传统凝血试验 TEG 相关性 

分 类 号：R4[医药卫生—临床医学]