血栓弹力图与ESRS评分≥3分患者凝血功能及早期神经功能恶化的关系  

Relationship between thromboelastogram and coagulation function and early neurological deterioration in patients with ESRS score≥3

作　　者：孟洁[1] 苏立贞 晋婕 MENG Jie;SU Lizhen;JIN Jie(Department of Blood Transfusion,Xi′an High-tech Hospital,Xi′an,Shaanxi 710075,China;Department of Reproductive Medicine,Xi′an High-tech Hospital,Xi′an,Shaanxi 710075,China;Xi′an Jinyu Medical Laboratory Co.LTD.,Xi′an,Shaanxi 710075,China)

机构地区：[1]西安高新医院输血科,陕西西安710075 [2]西安高新医院生殖医学科,陕西西安710075 [3]西安金域医学检验所有限公司,陕西西安710075

出　　处：《检验医学与临床》2022年第12期1653-1656,共4页Laboratory Medicine and Clinic

摘　　要：目的探讨血栓弹力图(TEG)与Essen卒中风险分层量表(ESRS)评分≥3分患者凝血功能及早期神经功能恶化(END)的关系。方法选择2020年1月至2021年8月西安高新医院收治的156例急性缺血性脑卒中(AIS)患者,入院后行TEG检查,按照ESRS评分将患者分为ESRS评分≥3分组(84例)与ESRS评分<3分组(72例)。比较两组的TEG指标[反应时间(R)、凝固时间(K)、最大切角(α角)、最大振幅(MA)]、凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、国际标准化比值(INR)]及END发生率,采用Spearman相关系数分析TEG指标与凝血功能指标的关系,采用多因素Logistic回归分析TEG指标对END发生的影响。结果ESRS评分≥3分组的R、K、APTT、PT、TT、INR水平明显低于ESRS评分<3分组(P<0.05),α角、MA、END发生率明显大于或高于ESRS评分<3分组(P<0.05)。R、K与APTT、PT、TT、INR均呈正相关(r>0,P<0.05),α角、MA与APTT、PT、TT、INR均呈负相关(r<0,P<0.05)。R缩短是END发生的独立危险因素(OR=1.249,95%CI:1.022~1.615,P<0.05)。结论TEG与ESRS评分≥3分患者凝血功能存在密切关系,TEG指标R与END发生存在独立相关性。Objective To investigate the relationship between thromboelastography(TEG)and coagulation function and early neurological deterioration(END)in Essen stroke risk stratification scale(ESRS)score≥3.Methods A total of 156 patients with acute ischemic stroke(AIS)who were selected in Xi′an High-tech Hospital from January 2020 to August 2021.The TEG examination was performed after admission.According to ESRS score,the patients were divided into ESRS score≥3 group(84 cases)and ESRS score<3 group(72 cases).The TEG indexes[reaction time(R),kinetics of clotdevelopment(K),maximum shear angle(αangle),maximum amplitude(MA)],coagulation function indexes[activated partial thrombin time(APTT),prothrombin time(PT),thrombin time(TT),international standardized ratio(INR)]and the occurrence of END were compared between two groups.The Spearman correlation coefficient was used to analyze the relationship between TEG indexes and coagulation function indexes,and the multi-factor Logistic regression was used to analyze the occurrence of TEG indexes on the occurrence of END.Results The levels of R,K,APTT,PT,TT,INR in ESRS score≥3 group were significantly lower than those in ESRS score<3 group(P<0.05),and theαangle,MA and occurrence of END were significantly higher than those in ESRS score<3 group(P<0.05).The R,K were positively correlated with APTT,PT,TT,INR(r>0,P<0.05),and theαangle,MA were negatively correlated with APTT,PT,TT,INR(r<0,P<0.05).The shortened R was an independent risk factor for occurrence of END(OR=1.249,95%CI:1.022-1.615,P<0.05).Conclusion The TEG is closely correlated with coagulation function in patients with ESRS score≥3,and TEG index R is independently correlated with the occurrence of END.

关 键 词：血栓弹力图 急性缺血性脑卒中 Essen卒中风险分层量表 凝血功能 早期神经功能恶化 

分 类 号：R730.43[医药卫生—肿瘤]