摘要
目的检测高血压脑出血患者入院前后凝血功能指标及血栓弹力图(TEG)参数,并分析其对患者预后的评估价值。方法选取2018年12月—2020年3月本院收治的高血压合并脑出血患者69例作为研究对象(观察组),依据入院24 h后头颅电子计算机断层扫描(CT)复查血肿量将患者分为再出血组(18例)和未再出血组(51例),另选取同期诊断为高血压未出现脑出血患者50例作为对照组。检测所有受试者入院时及经紧急治疗后6 h凝血功能指标,包括凝血酶原时间(PT)、凝血酶时间(TT)、活化的部分凝血酶时间(APTT)、纤维蛋白原(FIB),TEG参数包括凝血反应时间(R)、血凝块形成时间(K)、Angle值、最大振幅(MA)、30 min血凝块幅度减少速率(LY30)、凝血指数(CI)。结果与对照组相比,观察组入院时凝血功能指标PT、APTT、TT、FIB及TEG参数R、K、LY30水平均升高(P<0.05),Angle值、MA、CI水平均降低(P<0.05)。与未再出血组相比,再出血组入院治疗6 h凝血功能指标PT、APTT、TT、FIB及TEG参数R、K、LY30均升高,MA、CI水平均降低(P<0.05)。Logistic回归分析,结果显示,PT、TT、R、MA均是高血压患者发生脑出血的独立危险因素(P<0.05)。ROC曲线分析显示凝血功能指标PT、TT及TEG参数R、MA单项检测及联合检测均能较好的反应高血压脑出血患者预后不良情况。结论凝血功能指标及TEG参数均与高血压脑出血患者预后有密切关系,对预后不良情况的发生有一定诊断价值。
Objective To detect the coagulation function indexes and thromboelastography(TEG)parameters in patients with hypertensive cerebral hemorrhage before and after admission,and to analyze their prognostic value.Methods From December 2018 to March 2020,69 patients with hypertension and cerebral hemorrhage treated in our hospital were selected as the study objects(observation group),and according to the amount of hematoma reexamined by electronic computed tomography(CT)at 24 hours after admission,the patients were divided into hemorrhage group(18 cases)and non hemorrhage group(51 cases).In addition,50 patients with hypertension without cerebral hemorrhage at the same time were selected as the control group.The coagulation indexes,including prothrombin time(PT),thrombin time(TT),activated partial thrombin time(APTT),fibrinogen(FIB),and TEG parameters including coagulation reaction time(R),clot formation time(K),Angle value,maximum amplitude(MA),30 min clot amplitude reduction rate(LY30),coagulation index(CI),of all subjects at admission and 6 h after emergency treatment were measured.Results Compared with those in the control group,the coagulation indexes of PT,APTT,TT,FIB and TEG parameters of R,K,LY30 levels in the observation group at admission were higher(P<0.05),while the levels of Angle,MA and CI were lower(P<0.05).Compared with those in the non hemorrhage group,the PT,APTT,TT,FIB and R,K,LY30%of the patients in the hemorrhage group at 6 hours after admission were higher,and the levels of MA and CI were lower(P<0.05).The results of Logistic regression analysis showed that PT,TT,R and MA were independent risk factors of cerebral hemorrhage in patients with hypertension(P<0.05).ROC curve analysis showed that single tests and combined test of PT,TT and R,MA could reflect the poor prognosis of patients with hypertensive intracerebral hemorrhage.Conclusion The coagulation function indexes and TEG parameters are closely related to the prognosis of patients with hypertensive cerebral hemorrhage,all of them have certain d
作者
陈燕青
张奇
李婷婷
张铭媛
刘家俊
CHEN Yan-qing;ZHANG Qi;LI Ting-ting;ZHANG Ming-yuan;LIU Jia-jun(General Hospital of the Medical Community,Second Hospital of Shaoxing,Shaoxing,Zhejiang 312000,China)
出处
《中国卫生检验杂志》
CAS
2021年第14期1737-1740,1769,共5页
Chinese Journal of Health Laboratory Technology
基金
浙江省医药卫生科技计划项目(2018KY147)。
关键词
凝血功能
血栓弹力图
高血压脑出血
Coagulation function
Thromboelastography
Hypertensive cerebral hemorrhage
