血栓弹力图与脑出血患者近期临床预后的相关性分析  

Correlation between Thromboelastography and Short-term Prognosis of Cerebral Hemorrhage

作　　者：李铭辉 庹华斌 罗长稳 张纯化 罗显华[1] LI Ming-hui;TUO Hua-bin;LUO Chang-wen(Ankang Central Hospital,Ankang Shaanxi 725000)

机构地区：[1]安康市中心医院神经外科,陕西安康725000

出　　处：《医学临床研究》2022年第10期1456-1458,1462,共4页Journal of Clinical Research

摘　　要：【目的】探讨血栓弹力图(Thromboelastography,TEG)与脑出血患者近期临床预后的相关性。【方法】选择在本院住院治疗的89例脑出血患者,入组后检测患者TEG,同时进行头颅CT扫描,计算脑出血量;出院30 d后对患者进行Rankin预后等级量表评分(mRs)评估,根据mRs评分将患者分为预后良好组(n=71)及预后不良组(n=18),分析脑出血量及预后情况与TEG的关系。应用受试者工作特征(ROC)曲线评估TEG指标预测脑出血预后不佳的价值,通过多因素Logistic回归分析TEG指标与近期预后不良的相关性。【结果】与小量脑出血组及中量脑出血组相比,大量脑出血组患者凝血反应时间(R)显著延长,但最大振幅(MA)、α角及凝血综合指数(CI)显著减少。Pearson相关性分析提示:脑出血量与R为线性正相关(r=0.428,P<0.05),与MA(r=-0.561,P<0.05)及α角(r=-0.384,P<0.05)为线性负相关。与预后不良组相比,预后良好组患者R显著缩短,MA及CI显著增大(P<0.05)。ROC曲线分析可知,R预测预后不良的价值曲线下面积(AUC)(95%CI)为0.87(0.77~0.96)。多因素Logistic回归分析提示:R及MA与预后不良密切相关,两者优势比分别为2.25(1.16~4.38)及0.93(0.87~0.98)。【结论】TEG指标与脑出血患者出血量及近期预后相关,其中R是预后不良的独立危险因素,而CI是预后不良的保护因素。【Objective】To analyze the correlation between thromboelastography(TEG)and short-term prognosis of cerebral hemorrhage.【Methods】A total of 89 patients with cerebral hemorrhage who were admitted in our hospital were collected in our study.After enrollment,patients received both TEG and skull CT to calculate amount of cerebral hemorrhage.Rankin prognostic rating scale(mRs)was performed on the patients 30 days after discharge.According to the mRs score,patients were divided into good prognosis group(n=71)and poor prognosis group(n=18).The relationship of cerebral hemorrhage with prognosis and TEG was analyzed.The receiver operating characteristic(ROC)curve was used to evaluate value of TEG in predicting poor prognosis of cerebral hemorrhage in patients,and the relationship between TEG and poor prognosis was analyzed by using multivariate Logistic regression.【Results】Compared to small and moderate cerebral hemorrhage,the R time of a large cerebral hemorrhage was higher,while MA,angle and CI were lower,and Pearson correlation showed that the amount of cerebral hemorrhage had positive correlation with coagulation reaction time(R)was significantly prolonged in the massive intracerebral hemorrhage group,but the maximum amplitude(MA),αangle and coagulation comprehensive index(CI)were significantly shortened.Pearson correlation analysis showed that the amount of intracerebral hemorrhage was positively correlated with R(r=0.428,P<0.05),while it was negative correlation with MA(r=-0.561,P<0.05)and angle(r=-0.384,P<0.05).Compared with the poor prognosis group,patients with the good prognosis had shorter R time and longer MA and CI.The ROC curve showed that the area under the value curve(AUC)(95%CI)of R for predicting negative prognosis was 0.87(0.77-0.96).Multivariate Logistic regression analysis showed that R time and MA were closely related to the poor prognosis with odds ratios(OR)of 2.25(1.16-4.38)and 0.93(0.87-0.98),respectively.【Conclusion】TEG was related to amount of cerebral hemorrhage and short-term p

关 键 词：脑出血 血栓弹力描记术 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]