摘要
目的分析血栓弹力图(TEG)、血小板α颗粒膜蛋白-140(GMP-140)、纤溶酶原激活物抑制物1(PAI-1)联合检测对弥散性血管内凝血(DIC)的诊断价值。方法选取2020年2月至2021年8月于西安凤城医院就诊的168例疑似创伤合并DIC患者作为研究对象。根据中国弥散性血管内凝血诊断积分系统(CDSS)将患者分为DIC组(62例)和非DIC组(106例)。比较两组TEG参数[凝血反应时间(R值)、凝血形成时间(K值)、凝固角(α角)、血栓最大幅度(MA值)]、血浆GMP-140及PAI-1水平;根据创伤严重程度将168例患者分为轻伤组(56例)、重伤组(67例)和严重伤组(45例),比较不同创伤程度患者的TEG参数;采用受试者工作曲线(ROC)分析TEG参数、血浆GMP-140及PAI-1水平对DIC的联合诊断价值,并计算曲线下面积(AUC)。结果DIC组患者的TEG参数R值、K值及血浆GMP-140及PAI-1水平显著高于非DIC组(P<0.05),TEG参数α角、MA值显著低于非DIC组(P<0.05);随着创伤严重程度增加,患者的R值及K值逐渐升高,α角及MA值逐渐减小,不同创伤严重程度组间比较差异有统计学意义(P<0.05);ROC曲线分析显示,4项TEG参数(R值、K值、α角、MA值)、血浆GMP-140、PAI-1水平对创伤性DIC均有良好的诊断价值,其中4项TEG参数+GMP-140+PAI-1的诊断特异度(91.02%)均高于各项单独诊断。结论TEG参数对创伤合并DIC有良好的诊断价值,联合血浆GMP-140、PAI-1水平可更好地反映患者的凝血功能状态。
Objective To analyze the diagnostic value of combined detection of thromboelastography(TEG),plateletαgranular membrane protein-140(GMP-140)and plasminogen activator inhibitor 1(PAI-1)on disseminated intravascular coagulation(DIC).Methods 168 patients with suspected trauma complicated with DIC who were treated in the hospital between February 2020 and August 2021 were selected as the research subjects.According to the Chinese Diagnostic Scoring System for Disseminated Intravascular Coagulation(CDSS),the patients were divided into DIC group(n=62)and non-DIC group(n=106).The TEG parameters[coagulation response time(R value),coagulation formation time(K value),solidification angle(αangle),maximum thrombus amplitude(MA value)]and levels of plasma GMP-140 and PAI-1 were compared between the two groups.According to the severity of trauma,168 patients were divided into mild injury group(n=56),severe injury group(n=67)and severe injury group(n=45).The TEG parameters of patients with different injury degrees were used to analyze.Receiver operating characteristic curve(ROC)was used to analyze the combined diagnostic value of TEG parameters and levels of plasma GMP-140 and PAI-1 on DIC,and the area under the curve(AUC)was calculated.Results The TEG parameters(R value,K value)and levels of plasma GMP-140 and PAI-1 of DIC group were significantly higher than those of non-DIC group(P<0.05)while the TEG parameters(αangle,MA value)were significantly lower than those of non-DIC group(P<0.05).As the severity of trauma increased,the R value and K value of patients were gradually increased while theαangle and MA value gradually decreased,and there were statistically significant differences between the groups of different trauma severity(P<0.05).ROC analysis showed that the 4 TEG parameters(R value,K value,αangle,MA value)and levels of plasma GMP-140 and PAI-1 had good diagnostic value on traumatic DIC,and the diagnostic specificity of 91.02%of the 4 TEG parameters+GMP-140+PAI-1 was higher than that of each single diagnosis.Concl
作者
雷芳
杨瑞利
韩双
杨亚兴
王苗
郭晓波
无
LEI Fang;YANG Ruili;HAN Shuang;YANG Yaxing;WANG Miao;GUO Xiaobo;无(Xi′an Fengcheng Hospital,Xi′an,Shaanxi 710021,China;Chang′an Hospital,Xi′an,Shaanxi 710016,China;Xi'an Central Hospital,Xi'an,Shaanxi 710003,China)
出处
《检验医学与临床》
CAS
2022年第20期2760-2763,共4页
Laboratory Medicine and Clinic
基金
陕西省科技计划项目(2018SF-205)。
关键词
血栓弹力图
血小板Α颗粒膜蛋白-140
纤溶酶原激活物抑制物1
受试者工作曲线
thromboelastography
plateletαgranular membrane protein-140
plasminogen activator inhibitor 1
spearman correlation coefficient
receiver operating characteristic curve
