摘要
目的探究血栓弹力图(TEG)检测在急性白血病(AL)患者出血风险评估中的应用价值.方法选取2016年12月至2018年8月本院收治的178例AL患者,依据临床有无出血症状分为出血A组(n=71)与无出血A组(n=107);另筛查出血小板计数(PLT)计数<30×109/L的AL患者75例,同样依据临床有无出血症状分为出血B组(n=51)与无出血B组(n=24).均进行血常规及TEG检测,对比其PLT计数、TEG各指标,同时以无出血A组作为对照组,出血A组作为病例组,采用ROC曲线确定PLT计数、TEG各指标筛查AL患者出血症状的ROC曲线下面积(AUC).结果相较于无出血A组,出血A组PLT计数、凝固角及最大振幅较低,凝血反应时间及血凝块生成时间较长(P<0.05);两组PLT计数、凝血反应时间相比,差异无统计学意义;相较于无出血B组,出血B组最大振幅及凝固角较低,血凝块生成时间较长(P<0.05);凝固角筛查AL患者出血症状的AUC较血凝块生成时间、凝血反应时间大,但较PLT计数、最大振幅小(P<0.05).结论TEG可有效评估AL患者出血风险,其中最大振幅可作为PLT计数的有效补充,为临床治疗方案选择提供依据.
Objective To investigate the value of thromboelastography (TEG) in the assessment of bleeding risk in patients with acute leukemia (AL). Methods 178 patients with AL admitted to our hospital from December 2016 to August 2018 were divided into hemorrhagic group A (n=71) and no bleeding group A (n=107) according to clinical bleeding symptoms. Another 75 patients with AL who had a platelet count (PLT) count< 30×109/L were also screened for bleeding B group (n=51) and no bleeding B group (n=24). Blood routine and TEG were performed, and the PLT count and TEG indexes were compared. The non-bleeding group A was used as the control group, and the bleeding group A was used as the case group. The ROC curve was used to determine the PLT count and TEG. The index screened the area under the ROC curve (AUC) for bleeding symp- toms in AL patients. Results Compared with the non-bleeding group A, the PLT count, the coagulation angle and the maximum amplitude were lower in the bleeding group A, and the coagulation reaction time and blood clot generation time were longer (P<0.05). The PLT count and coagula- tion reaction time were compared between the two groups. There was no significant difference. Compared with the non-bleeding group B, the maxi- mum amplitude and coagulation angle of the bleeding group B were lower, and the blood clot formation time was longer (P<0.05). The coagula- tion angle was used to screen the bleeding symptoms of AL patients. The AUC was larger than the blood clot generation time and the coagulation reaction time, but it was smaller than the PLT count and the maximum amplitude (P<0.05). Conclusion TEG can effectively evaluate the bleed- ing risk of AL patients, and the maximum amplitude can be used as an effective supplement for PLT count, which provides a strong basis for clini- cal treatment options.
作者
苏礼华
刘丽仙
Su Lihua;Liu Lixian(Department of Blood Transfusion,The People's Hospital of Lincang,Lincang,Yunnan,677000,China;Department of Inspection Division,The People's Hospital of Lincang,Lincang,Yunnan,677000,China)
出处
《当代医学》
2019年第35期98-100,共3页
Contemporary Medicine
