血栓弹力图参数对急性脑梗死严重程度的评估价值  

Evaluation value of thromboelastography parameters on the severity of acute cerebral infarction

作　　者：张苏伟[1] 范丽英 李佳真[1] ZHANG Su-wei;FAN Li-ying;LI Jia-zhen(Department of Clinical Laboratory,Shantou Central Hospital,Shantou 515041,Guangdong,China;Department of Clinical Laboratory,the Second People′s Hospital of Shantou,Shantou 515041,Guangdong,China)

机构地区：[1]汕头市中心医院检验科,广东省汕头市515041 [2]汕头市第二人民医院检验科,广东省汕头市515041

出　　处：《广西医学》2022年第15期1697-1700,共4页Guangxi Medical Journal

基　　金：广东省医学科研基金(B2019240)。

摘　　要：目的 探讨血栓弹力图(TEG)参数对急性脑梗死严重程度的评估价值。方法 回顾性分析278例急性脑梗死患者的临床资料,将患者按照美国国立卫生研究院卒中量表(NIHSS)评分分为3组:轻度组(NIHSS评分<4分)、中度组(4分≤NIHSS评分<15分)和重度组(NIHSS评分≥15分)。比较入院次日不同严重程度的急性脑梗死患者的凝血反应时间(R)、血凝块形成时间(K值)、凝固角(α角)、最大振幅(MA)和凝血综合指数(CI)等TEG参数,采用受试者工作特征(ROC)曲线评估TEG参数对轻/中度与重度急性脑梗死的鉴别价值。结果 重度组患者R、K值均短于轻、中度组患者,α角、MA均大于轻、中度组(均P<0.05);中度组与轻度组的R、K值、α角和MA比较,差异均无统计学意义(均P>0.05)。ROC曲线分析结果显示:R、K值、α角、MA单独诊断重度急性脑梗死的曲线下面积分别为0.860、0.779、0.831、0.823,灵敏度分别为100.00%、73.68%、84.21%、94.65%,特异度分别为60.82%、66.70%、75.44%、66.11%,其中R诊断重度急性脑梗死的灵敏度最高,α角的特异度最高。结论 TEG参数可作为评估急性脑梗死严重程度的实验室指标,对于鉴别轻/中度与重度急性脑梗死有较好的价值。Objective To explore the evaluation value of thromboelastography(TEG) parameters on the severity of acute cerebral infarction.Methods The clinical data of 278 patients with acute cerebral infarction were retrospectively analyzed,and they were assigned to three groups according to the National Institutes of Health Stroke Scale(NIHSS) score as follows:the mild group(NIHSS score0.05).The results of ROC curve analysis revealed that the areas under the curve of R,K value,α angel and MA diagnosing severe acute cerebral infarction alone were 0.860,0.779,0.831,and 0.823,and the sensitivities were 100.00%,73.68%,84.21%,94.65%,the specificities were 60.82%,66.70%,75.44%,and 66.11%,respectively,thereinto the sensitivity of R for diagnosing severe acute cerebral infarction was the highest,and the specificity of α angel was the highest.Conclusion TEG parameters can be used as the laboratory indexes to evaluate the severity of acute cerebral infarction,which exerts a preferable value on differential diagnosis of mild/moderate from severe acute cerebral infarction.

关 键 词：急性脑梗死 疾病程度 重度 血栓弹力图 参数 评估 

分 类 号：R445.9[医药卫生—影像医学与核医学] R743.33[医药卫生—诊断学]