摘要
目的利用血栓弹力图(TEG)检测不同状态下的急性缺血性脑卒中(AIS)患者的凝血特征。方法以2020年3—9月初诊的183例AIS患者为研究对象,收集其TEG参数及临床资料等相关危险因素,以不同危险因素分组,比较组间TEG参数的差异。结果(1)与青年组相比,老年组的TEG参数K值显著降低(1.96±0.73 vs.2.81±4.20),而Angle值、MA值、CI值和G值则显著升高(分别为63.59±7.40 vs.59.04±10.09、62.75±5.84 vs.60.77±6.33、0.09±2.13 vs.-0.85±2.37、8.76±2.29 vs.8.08±2.12),比较差异均有统计学意义(P<0.05)。(2)青年组AIS患者的K值与PLT值之间成负相关(r=-0.281,P=0.013);Angle值与PLT值之间成正相关(r=0.277,P=0.015);MA值与PLT值、FIB值之间成正相关(r=0.496、0.365,P<0.001);CI值与PLT值之间成正相关(r=0.272,P=0.017);G值与PLT值和FIB值之间成正相关(r=0.496、0.362,P<0.001)。(3)与未合并冠心病的AIS患者相比,合并冠心病的AIS患者的K值显著降低(2.40±3.05 vs.1.93±0.80),而Angle值则显著升高(61.16±8.92 vs.64.20±8.47);与无脑卒中病史的AIS患者相比,有脑卒中病史的AIS患者的K值显著降低(2.56±3.47 vs.1.90±0.65),而Angle值(60.82±8.20 vs.63.15±9.89)、MA值(61.09±6.60 vs.63.36±4.87)同样显著升高。(4)TEG参数在脑卒中大动脉粥样硬化型和小动脉闭塞型之间差异无统计学意义(P>0.05),但大动脉粥样硬化型脑卒中患者的住院天数要显著长于小动脉闭塞患者住院天数比较差异无统计学意义(19.04±13.25 vs.14.01±8.01,P=0.031)。结论有高龄、冠心病和脑卒中史的AIS患者的K值更短,Angle值更高,应重点关注年龄、冠心病和脑卒中史对AIS患者凝血状态的影响,TEG检测将有助于AIS的及时诊疗。有高龄、冠心病和脑卒中史的AIS患者的K值更短,Angle值更高,应重点关注年龄、冠心病和脑卒中史对AIS患者凝血状态的影响,TEG检测将有助于AIS的及时诊疗。
Objective To detect and compare the coagulation characteristics of patients with acute ischemic stroke(AIS)of different status by thromboelastography(TEG).Methods 183 patients with AIS who were newly diagnosed from March to September 2020 were involved in the study.The TEG parameters and clinical data and other related risk factors were collected and grouped by different risk factors.The differences in TEG parameters between the groups were compared.Results Compared with the young group,the TEG parameter K value of the elderly group was significantly reduced(1.96±0.73 vs.2.81±4.20),while the Angle value,MA value,CI value and G value were significantly increased(63.59±7.40 vs.59.04±10.09,62.75±5.84 vs.60.77±6.33,0.09±2.13 vs.-0.85±2.37,8.76±2.29 vs.8.08±2.12,P<0.05).(2)There is a negative correlation between K value and PLT value in the young group(r=-0.281,P=0.013);there is a positive correlation between Angle value and PLT value(r=0.277,P=0.015);there is a positive correlation between MA value and PLT value,FIB value(r=0.496,0.365,P<0.001);the CI value is positively correlated with the PLT value(r=0.272,P=0.017);the G value is positively correlated with PLT value,FIB values(r=0.496,0.362,P<0.001).(3)The K value of AIS patients with coronary heart disease was significantly lower than that in AIS patients without coronary heart disease(2.40±3.05 vs.1.93±0.80),the Angle value was significantly higher than that in AIS patients without coronary heart disease(61.16±8.92 vs.64.20±8.47);the K value of AIS patients with a history of stroke was significantly lower than that in AIS patients without a history of stroke(2.56±3.47 vs.1.90±0.65),While the Angle value and MA value are also significantly higher than those in AIS patients without coronary heart disease(60.82±8.20 vs.63.15±9.89;61.09±6.60 vs.63.36±4.87).(4)There was no statistically difference in TEG parameters between large atherosclerotic stroke and small artery occlusion,but the length of stay in patients with large atherosclerotic stroke wa
作者
刘坤
闫彬
贾彦巍
许词
范春晖
LIU Kun;YAN Bin;JIA Yanwei;XU Ci;FAN Chunhui(Department of Clinical Laboratory Medicine,the Affiliated Nanshi Hospital of Henan University,Henan 473000,China;Department of Clinical Laboratory Medicine,Nanyang Central Hospital,Nanyang,Henan 473000,China;Department of Blood Transfusion,Nanyang Central Hospital,Nanyang,Henan 473000,China;Department of Neurology,Nanyang Central Hospital,Nanyang,Henan 473000,China)
出处
《检验医学与临床》
CAS
2022年第S01期13-17,共5页
Laboratory Medicine and Clinic
基金
河南省重点研发与推广专项科技攻关项目(212102310805)。
