血栓弹力图检测在脑梗死诊断及评估预后中的应用价值  

Application value of thromboelastography in diagnosis and prognosis evaluation of cerebral infarction

作　　者：陈浩峰 陈德杰 叶伙梅 CHEN Haofeng;CHEN Dejie;YEHuomei(Department of Blood Transfusion,Yunfu People’s Hospital,Guangdong,Yunfu 527300,China)

机构地区：[1]广东省云浮市人民医院输血科,广东云浮527300

出　　处：《中国医药科学》2024年第17期173-176,共4页China Medicine And Pharmacy

基　　金：广东省云浮市科技计划项目(WS2022031006)。

摘　　要：目的通过对脑梗死患者的血栓弹力图(TEG)、凝血四项、D-二聚体(D-D)检测结果进行分析,评价TEG检测在脑梗死诊断及评估预后中的应用价值。方法选取2020年3月至2023年7月云浮市人民医院收治的脑梗死患者100例和健康体检人员80名为研究对象,对两组进行TEG、凝血四项、D-D检测并分析。结果观察组的凝血反应时间(R)、凝血形成时间(K)低于对照组,最大振幅(MA)、D-D高于对照组,差异均有统计意义(P<0.05)。观察组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)与对照组比较差异无统计意义(P>0.05)。观察组的重度脑梗亚组的R、K低于轻度脑梗亚组,MA、D-D高于轻度脑梗亚组,差异均有统计意义(P<0.05)。重度脑梗亚组的R、K低于中度脑梗亚组,MA、D-D高于中度脑梗亚组,差异均有统计意义(P<0.05)。中度脑梗亚组的R、K低于轻度脑梗亚组,MA、D-D高于轻度脑梗亚组,差异均有统计意义(P<0.05)。观察组的R与APTT呈正相关(P<0.01),MA与FIB呈正相关(P<0.01),K与FIB呈负相关(P<0.01)。结论相比常规凝血指标,TEG对脑梗死的诊断有重要的临床价值,神经缺血性损伤程度越严重,TEG高凝状态越明显,对脑梗死的预后评估有重要帮助。TEG是脑梗死诊断及预后评估的良好指标,值得在临床上推广应用。Objective To analyze the results of thromboelastography(TEG),coagulation and D-D in patients with cerebral infarction,and to evaluate the application value of TEG in the diagnosis and prognosis of cerebral infarction.Methods From March 2020 to July 2023,100 patients with cerebral infarction and 80 healthy individuals who underwent physical examinations at Yunfu People’s Hospital were selected as the research subjects.TEG,coagulation,and D-D tests were performed and analyzed on the two groups.Results The coagulation reaction time(R)and clotting time(K)of the observation group were lower than those of the control group,while the maximum amplitude(MA)and D-D were higher than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in prothrombin time(PT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)between the observation group and the control group(P>0.05).The R and K of the severe cerebral infarction subgroup in the observation group were lower than those in the mild cerebral infarction subgroup,while the MA and D-D were higher than those in the mild cerebral infarction subgroup,and the differences were statistically significant(P<0.05).The R and K of the severe cerebral infarction subgroup were lower than those of the moderate cerebral infarction subgroup,while the MA and D-D were higher than those of the moderate cerebral infarction subgroup,and the differences were statistically significant(P<0.05).The R and K of the moderate cerebral infarction subgroup were lower than those of the mild cerebral infarction subgroup,while the MA and D-D were higher than those of the mild cerebral infarction subgroup,and the differences were statistically significant(P<0.05).The R of the observation group was positively correlated with APTT(P<0.01),MA was positively correlated with FIB(P<0.01),and K was negatively correlated with FIB(P<0.01).Conclusion Compared with conventional coagulation indicators,TEG has important clinical val

关 键 词：血栓弹力图 脑梗死 凝血 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]