摘要
目的:探讨血栓弹力图(TEG)联合常规凝血指标对脑梗死患者预后不良的预测价值。方法:回顾性分析2020年10月至2022年10月该院收治的120例脑梗死患者的临床资料,所有患者在入院当天检测TEG参数[凝血因子反应时间(R)、血凝块形成时间(K)、血凝块形成速率(α角)、血栓形成最大振幅(MA)]和常规凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶原时间(APTT)及纤维蛋白原(FIB)],根据溶栓治疗后3个月时的改良Rankin量表(mRS)评分将其分为预后良好组(n=78,mRS评分≤2分)和预后不良组(n=42,mRS评分≥3分)。比较两TEG参数、常规凝血指标水平,并采用受试者工作特征(ROC)曲线分析TEG参数联合常规凝血指标对脑梗死患者预后不良的预测价值。结果:预后不良组R值、K值小于预后良好组,α角、MA值大于预后不良组,FIB水平高于预后良好组,差异均有统计学意义(P<0.05);两组PT、TT、APTT水平比较,差异无统计学意义(P>0.05);ROC曲线分析结果显示,TEG参数R值、K值、α角、MA值及FIB水平单项检测预测脑梗死患者预后不良的曲线下面积分别为0.726、0.713、0.828、0.688、0.739,联合检测的曲线下面积为0.988,预测价值高于各指标单项检测。结论:PT、TT、APTT等常规凝血指标对血栓形成及脑梗死预后的预测价值存在局限性。R值、K值减小,α角、MA值增大,FIB水平升高的脑梗死患者出现预后不良的风险更高。TEG参数与FIB水平联合检测对脑梗死患者预后不良的预测价值高于单项指标检测。
Objective:To explore predictive value of thrombelastogram(TEG)combined with conventional coagulation indexes detection for poor prognosis in patients with cerebral infarction.Methods:The clinical data of 120 patients with cerebral infarction admitted to this hospital from October 2020 to October 2022 were retrospectively analyzed.All patients underwent TEG parameters[coagulation factor reaction time(R),blood clot formation time(K),blood clot formation rate(αangle),maximum amplitude of thrombus formation(MA)]and routine coagulation indexes[prothrombin time(PT),thrombin time(TT),activated partial prothrombin time(APTT)and fibrinogen(FIB)]detection on the day of admission.According to the modified Rankin scale(mRS)score 3 months after thrombolysis,these patients were divided into good prognosis group(n=78,mRS≤2)and poor prognosis group(n=42,mRS≥3).The levels of TEG parameters and conventional coagulation indexes were compared between the two groups.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of TEG parameters combined with conventional coagulation indexes for the poor prognosis of the patients with cerebral infarction.Results:The R value and the K value of the poor prognosis group were lower than those of the good prognosis group,theαangle and the MA value were higher than those of the poor prognosis group,the FIB level was higher than that of the good prognosis group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the levels of PT,TT,and APTT between the two groups(P>0.05).ROC curve analysis showed that the areas under the curve of TEG parameters R value,K value,αangle,MA value and single FIB detection in the prediction the poor prognosis of the patients with cerebral infarction was 0.726,0.713,0.828,0.688 and 0.739,separately.The area under the curve of combined detection was 0.988,and its predictive value was higher than that of single index detection.Conclusions:The predictive value of convention
作者
李振亚
LI Zhenya(Department of Clinical Laboratory of Zhengzhou TCM Hospital,Zhengzhou 450000 Henan,China)
出处
《中国民康医学》
2023年第22期126-129,共4页
Medical Journal of Chinese People’s Health
关键词
脑梗死
血栓弹力图
凝血指标
纤维蛋白原
预后
预测价值
Cerebral infarction
Thrombelastogram
Coagulation index
Fibrinogen
Prognosis
Predictive value
