摘要
目的 分析血栓弹力图(thromboelastography,TEG)对急性脑梗死(acute cerebral infarction,ACI)院内预后不良的影响.方法 随机连续纳入2015年11月—2017年11月就诊于南京医科大学附属淮安第一医院神经内科的ACI患者共147例.所有患者入院后均完善TEG等相关检查,记录患者在院期间发生不良事件的情况.将患者分为预后不良组(n=34)及预后不良组(n=113),分析两组患者临床资料及TEG指标之间的差异.通过多因素Logistic回归分析影响预后不良的临床因素.结果 与预后良好组相比,预后不良组患者低密度脂蛋白胆固醇(LDL-C)、美国国立卫生院脑卒中量表(NIHSS)评分、超敏C反应蛋白(hs-CRP)显著升高,凝血反应时间(R)和血形成时间(K)显著缩短.NIHSS评分高水平以及K和R时间与ACI患者发生院内预后不良有关,其优势比(OR)(95%CI)分别为7.92(6.85~9.15)、0.93(0.92~0.95)及0.96(0.94~0.99).结论 TEG中K及R时间是ACI院内预后不佳的独立危险因素.
Objective To analyze the influence of thromboelastography(TEG)on negative prognosis in patients with acute cerebral infarction(ACI).Methods A total of 147 patients with ACI who were admitted to department of neurology in our hospital between November 2015 and November 2017 were randomLy and consecutively included in this study.TEG of them were detected,and adverse events of them were followed-up in-hospital,meanwhile,all of them were divided intopositive prognosis group(n=34)and negative prognosis group(n=113)according to prognosis.The clinical characteristics and level of TEG were compared with two groups,and the relationship between clinical indicators and negative prognosis were analyzed by using multivariate logistic regression.Results It was found that:①the level of LDL-C,NIHSS scoresand hs-CRP in negative prognosis group were significantly higher than those in positive prognosis;②K and R times in patients with negative prognosis were significantly shorter than those in positive prognosis patients;③NIHSS scores and K and R time hadcorrelation with negative prognosis in-hospital of patients ACI,and their odds ratios(OR)(95%CI)were 7.92(6.85~9.15),0.93(0.92~0.95)and 0.96(0.94~0.99).Conclusions The R and K time in TEG severed as an independent risk factor negative prognosis in-hospital of patients ACI.
作者
朱晓峰
王成云
夏磊
佟强
ZHU Xiaofeng;WANG Chengyun;XIA Lei;TONG Qiang(Department of Neurology,the Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huai'an Jiangsu 223300,China)
出处
《中国急救复苏与灾害医学杂志》
2020年第10期1195-1197,共3页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省基础研究计划(自然科学基金)面上项目(编号:BK20191212)。
关键词
血栓弹力图
急性脑梗死
院内预后
危险因素
Thromboelastography
Acute cerebral infarction
Prognosis in-hospital
Risk factors
