AECOPD患者血栓弹力图指标与凝血指标的相关性  

Correlation between Thromboelastography and Coagulation Indicators in Patients with AECOPD

作　　者：潘洁萍 张海华 PAN Jie-ping;ZHANG Hai-hua(Department of Pulmonary Medicine,Nanhua Hospital,Pudong New District,Shanghai 201399)

机构地区：[1]上海市浦东新区南华医院肺内科,上海201399

出　　处：《医学临床研究》2022年第12期1834-1836,1840,共4页Journal of Clinical Research

摘　　要：【目的】探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者血栓弹力图(TEG)指标与凝血指标的相关性。【方法】招募2018年1月至2020年1月因AECOPD就诊于本院的106例患者,收集患者凝血指标及TEG指标,采用Pearson分析TEG指标与凝血指标的相关性;同时根据患者过去一年病情发作次数及入院时肺功能情况分为低危组(n=61)及高危组(n=45),比较两组患者TEG指标的差异,采用受试者工作特征(ROC)曲线分析TEG指标对高危COPD的预测价值。【结果】Pearson相关性分析显示:血块成形时间(K)及凝血因子激活时间(R)与活化部分凝血酶时间(APTT)呈线性正相关(r=0.361、0.428);最大血块强度(MA)与纤维蛋白原(FIB)呈线性正相关(r=0.537),与D-二聚体(D-D)呈负相关(r=-0.381)。低危组患者K、R短于高危组,凝血综合指数(CI)显著低于高危组(P<0.05);R、K及CI预测高危COPD患者的曲线下面积(AUC)(95%CI)分别为0.87(0.81~0.94)、0.80(0.71~0.89)及0.66(0.56~0.77),三者最佳截断值(约登指数最大)分别为3.62 min、4.75 min及2.04。【结论】TEG指标与AECOPD患者凝血指标有相关性,其可用于预测高危COPD患者。【Objective】To investigate the correlation between thromboelastography(TEG)and coagulation indicators in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).【Methods】All 106 patients with AECOPD were recruited from our hospital between January 2018 and January 2020.The coagulation indicators and TEG were detected.The correlation between TEG and coagulation indicators was analyzed by Pearson correlation.At the same time,patients were divided into the low-risk group(n=61)and the high-risk group(n=45),according to the number of AECOPD attacks and changes in lung function in the past year.Receiver operating characteristic(ROC)curve was used to explore the value of TEG in estimating risk of COPD.【Results】Pearson correlation analysis showed that K(clot formation time)and R(coagulation factor activation time)had positively correlated with APTT(activated partial thrombin time),and the correlation coefficient correlation were 0.361 and 0.428,respectively.Meanwhile,MA(maximum clot strength)was positively correlated with FIB(fibrinogen),while MA was negatively correlated to D-D(D-dimer);and the correlation coefficient were 0.537 and-0.381,respectively.The K and R in the low-risk group were significantly shorter than high-risk group;the coagulation index(CI)was significantly lower than that of the high-risk group(P<0.05).The area under curve(AUC)of R time,K time and CI in the high-risk COPD were 0.87(0.81-0.94),0.80(0.71-0.89),and 0.66(0.56-0.77),respectively,and their optimal threshold was 3.62 min,4.75 min and 2.04,respectively.【Conclusion】TEG was correlated with coagulation indicators in patients with AECOPD,and it can be used to identify high-risk COPD patients.

关 键 词：肺疾病 慢性阻塞性 血栓弹力描记术 血液凝固 

分 类 号：R563[医药卫生—呼吸系统]