缺血性脑血管病血栓弹性成像与常规凝血试验的比较研究

Bin Yan, Tianxi Hu, Xin Li, Shi-qi Lu, Qi Wang, Guangjian Xu, Shu-Fang Pei, Yiming Zhao, C. Ruan
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The ROC curve was used to analyze the predictive value of TEG parameters for abnormal results of CCTs, and the results of TEG and CCTs were comprehensively analyzed to evaluate the ability to predict the coagulation status of patients. Results (1) PLT was positively correlated with MA value and G value; PT and APTT were positively correlated with K value; TT was positively correlated with R value and K value; FIB was positively correlated with Angle value, MA value and G value. TT was negatively correlated with Angle value and CI value; FIB was negatively correlated with K value. (2) PT and MA values, PT and G values, FIB and MA values, FIB and G values were accordant in valuing the hypoxic state of ICVD patients. 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引用次数: 0

摘要

目的探讨血栓弹性成像(TEG)与传统凝血试验(CCTs)在缺血性脑血管病(ICVD)诊断中的相关性和一致性。方法选取2018年5月1日至10月31日南阳市中心医院住院的ICVD患者108例。收集患者TEG参数(R值、K值、Angle值、MA值、CI值、G值)和CCTs参数(PT、APTT、TT、FIB)并进行回顾性分析。采用Spearman相关系数探讨TEG与CCTs参数的相关性,采用Kappa (κ)法探讨判定患者凝血状态的一致性。采用ROC曲线分析TEG参数对cct异常结果的预测价值,综合分析TEG和cct结果,评价TEG对患者凝血状态的预测能力。结果(1)PLT与MA值、G值呈正相关;PT、APTT与K值呈正相关;TT与R值、K值呈正相关;FIB与角度值、MA值、G值呈正相关。TT与角度值、CI值呈负相关;FIB与K值呈负相关。(2) PT与MA值、PT与G值、FIB与MA值、FIB与G值在评价ICVD患者缺氧状态时具有一致性。(3)评价ICVD患者高凝状态的PLT与Angle值、PLT与MA值、PLT与CI值、PLT与G值一致;FIB与Angle值、FIB与MA值、FIB与CI值、FIB与G值在评价ICVD患者高凝状态时具有一致性。(4)检测TT>20 s时,K值和Angle值的AUC分别为0.648、0.651;检测FIB>4 g/L时,Angle值和MA值的AUC分别为0.717和0.747;检测PLT>300×109/L时,MA值AUC为0.808(均P<0.05)。结论ICVD患者TEG与CCTs参数相关性和一致性较弱。TEG参数对评价cct异常结果有较好的预测价值,但不能代替cct。这两种方法的结合可以更好地反映患者的凝血状况,从而提供帮助。关键词:血栓弹性成像;常规凝血试验;缺血性脑血管病;缺血性中风;比较
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The comparative study between thromboelastography and conventional coagulation tests in ischemic cerebral vascular disease
Objective To explore the correlation and consistency between thromboelastography (TEG) and traditional coagulation tests (CCTs) in ischemic cerebral vascular disease (ICVD). Methods Totally 108 ICVD patients admitted to Nanyang Central Hospital from May 1 to October 31 2018 were enrolled. Patients’ TEG parameters (R value, K value, Angle value, MA value, CI value and G value) and CCTs parameters (PT, APTT, TT, and FIB) were collected and analyzed retrospectively. The Spearman correlation coefficient was used to explore the correlation between TEG and CCTs parameters, and Kappa (κ) to explore the consistency in determining the coagulation status of the patients. The ROC curve was used to analyze the predictive value of TEG parameters for abnormal results of CCTs, and the results of TEG and CCTs were comprehensively analyzed to evaluate the ability to predict the coagulation status of patients. Results (1) PLT was positively correlated with MA value and G value; PT and APTT were positively correlated with K value; TT was positively correlated with R value and K value; FIB was positively correlated with Angle value, MA value and G value. TT was negatively correlated with Angle value and CI value; FIB was negatively correlated with K value. (2) PT and MA values, PT and G values, FIB and MA values, FIB and G values were accordant in valuing the hypoxic state of ICVD patients. (3) PLT and Angle values, PLT and MA values, PLT and CI values, PLT and G values were accordant in assessing hypercoagulable status of ICVD patients; FIB and Angle values, FIB and MA values, FIB and CI value, and FIB and G value were consistent in evaluating the hypercoagulable state of ICVD patients. (4) For detecting TT>20 s, the AUC of K value and Angle value were 0.648, 0.651, respectively; For detecting FIB>4 g/L, the AUC of Angle value and MA value were 0.717 and 0.747, respectively; For detecting PLT>300×109/L, the AUC of MA value was 0.808 (all P<0.05). Conclusions There is weak correlation and consistency between TEG and CCTs parameters in ICVD patients. The TEG parameters have good predictive value in evaluating the abnormal results of CCTs, but cannot replace the CCTs. Combination of these two methods can better reflect the coagulation status of patients, so as to afford assistance. Key words: Thromboelastography; Conventional coagulation tests; Ischemic cerebral vascular disease; Ischemic stroke; Comparation
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中华急诊医学杂志
中华急诊医学杂志 Nursing-Emergency Nursing
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期刊介绍: Chinese Journal of Emergency Medicine is the only national journal which represents the development of emergency medicine in China. The journal is supervised by China Association of Science and Technology, sponsored by Chinese Medical Association, and co-sponsored by Zhejiang University. The journal publishes original research articles dealing with all aspects of clinical practice and research in emergency medicine. The columns include Pre-Hospital Rescue, Emergency Care, Trauma, Resuscitation, Poisoning, Disaster Medicine, Continuing Education, etc. It has a wide coverage in China, and builds up communication with Hong Kong, Macao, Taiwan and international emergency medicine circles.
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