重型血友病A患儿关节出血与血FⅧ活性及TEG指标的关系研究  

Study on the Relationship between Joint Hemorrhage and the Activity of Blood FⅧand TEG Index in Children with severe Hemophilia A

作　　者：刘云婧 LIU Yunjing(Laboratory of Hematology,Affiliated Children's Hospital of Zhengzhou University(Zhengzhou Children's Hospital of Henan Province),Zhengzhou Henan 450000,China)

机构地区：[1]郑州大学附属儿童医院(河南省儿童医院郑州儿童医院)血液病实验室,河南郑州450000

出　　处：《临床研究》2022年第11期35-38,共4页Clinical Research

摘　　要：目的探讨重型血友病A患儿关节出血与血FⅧ活性(FⅧ:C)及血栓弹力图(TEG)指标的关系。方法回顾性选取2019年1月至2022年1月在郑州大学附属儿童医院收治的76例重型血友病A患儿作为研究对象,根据是否伴有关节出血分组为出血组(N=22)与未出血组(N=54)。收集患儿一般临床资料,比较出血组与未出血组活化部分凝血酶原时间(APTT)、血友病关节健康评分(HJHS)、FⅧ:C和TEG检测指标,Pearson相关性分析APTT、HJHS与FⅧ:C的关系,APTT、HJHS评分与TEG检测指标的关系。结果出血组重型血友病A患儿APTT、HJHS低于未出血组,差异有统计学意义(P<0.05),凝血反应时间(R)、血凝块形成时间(K)、到达最大速度需要时间(TMRTG)水平均高于未出血组,差异有统计学意义(P<0.05)。重型血友病A患儿APTT与R、K、TMRTG均呈正相关,差异有统计学意义(r=0.412、0.435和0.434,P<0.05),HJHS评分与R、K、TMRTG均呈正相关,差异有统计学意义(r=0.426、0.441和0.410,P<0.05),APTT与a角、MRTG均呈负相关,差异有统计学意义(r=-0.314和-0.379,P<0.05),HJHS评分与a角、MRTG均呈负相关,差异有统计学意义(r=-0.337和-0.368,P<0.05)。结论重型血友病A患儿关节出血与FⅧ:C水平呈负相关,与TEG中R、K、TMRTG均呈正相关,与a角、MRTG均呈负相关,临床可通过FⅧ:C和TEG指标检测提供一定参考和帮助。Objective To investigate the relationship between joint hemorrhage,blood FⅧactivity(FⅧ:C)and TEG in children with severe hemophilia A.Methods A total of 76 children with severe hemophilia A who were admitted to the Affiliated Children’s Hospital of Zhengzhou University from January 2019 to January 2022 were retrospectively selected as the study subjects.They were divided into bleeding group(N=22)and non-bleeding group(N=54)according to whether there was joint bleeding.The general clinical data of children were collected,and the activated partial thromboplastin time(APTT),hemophilia joint health score(HJHS),FⅧ:C and TEG test indexes were compared between the bleeding group and the non-bleeding group.Pearson correlation analysis was used to analyze the relationship between APTT,HJHS and FⅧ:C,and the relationship between APTT,HJHS and TEG test indexes.Results The APTT and HJHS levels of children with severe hemophilia A in the bleeding group were lower than those in the non-bleeding group(P<0.05),and the levels of coagulation reaction time(R),blood clot formation time(K),and time to maximum velocity(TMRTG)in the bleeding group were higher than those in the non-bleeding group(P<0.05).APTT was positively correlated with R,K and TMRTG in children with severe hemophilia A,and the difference was statistically significant(r=0.412,0.435 and 0.434,P<0.05).HJHS score was positively correlated with R,K and TMRTG,and the difference was statistically significant(r=0.426,0.441 and 0.410,P<0.05).APTT was negatively correlated with angle a and MRTG,and the difference was statistically significant(r=-0.314 and-0.379,P<0.05).HJHS score was negatively correlated with angle a and MRTG,the difference was statistically significant(r=-0.337 and-0.368,P<0.05).Conclusion Joint hemorrhage in children with severe hemophilia A was negatively correlated with the level of FⅧ:C,positively correlated with R,K,TMRTG in TEG,negatively correlated with angle a and MRTG.The clinical examination of FⅧ:C and TEG can provide some reference

关 键 词：儿童重型血友病A 关节出血 血FⅧ活性 血栓弹力图指标 相关性 

分 类 号：R725.5[医药卫生—儿科]