摘要
目的:分析急性脑梗死(ACI)患者血栓弹力图(TEG)参数与血清学指标的相关性。方法:选择在本院接受治疗的116例ACI患者为ACI组,常规体检的非脑梗死人群98例为健康对照组。根据患者急性期神经功能缺损严重程度,ACI组再分为轻度脑梗组(51例),中度脑梗组(32例)和重度脑梗组(33例)。测定比较各组的TEG参数和血清血小板活化指标的变化,并分析TEG参数与血清血小板活化指标水平的相关性。结果:与健康对照组比较,ACI组治疗后TEG的R值[(6.17±1.38)min比(5.26±0.77)min]和K值[(2.39±0.53)min比(1.71±0.58)min]显著降低,α角[(63.27±9.23)deg比(77.45±12.08)deg]、MA值[(55.09±6.38)mm比(77.13±13.25)mm],凝血综合指数[CI,(1.68±0.53)比(2.56±0.87)]、D-二聚体[(0.24±0.07)mg/L比(0.38±0.09)mg/L]及血小板聚集率[PAR,(56.12±6.75)%比(69.17±9.33)%]水平显著升高,P均<0.05。不同程度ACI组间,神经功能缺损程度越严重,R值和K值越低,α角、MA值、CI值、D-二聚体和PAR水平越高,两两比较有显著差异(P<0.05或<0.01)。一元线性回归分析显示PAR与R值(B=-2.254)和K值(B=-2.286)呈显著负相关,与α角(B=2.536)、MA值(B=2.537)、CI值(B=2.352)呈显著正相关(P<0.05或<0.01);D-二聚体水平与R值(B=-2.276)和K值(B=-2.259)呈显著负相关,与α角(B=2.621)、MA值(B=2.462)、CI值(B=2.647)呈显著正相关(P<0.05或<0.01)。结论:急性脑梗死患者的TEG参数与血小板活性指标存在较强相关性,TEG对于此类患者的诊断、严重度判断、治疗指导均甚有价值。
Objective： To analyze correlation between thrombelastograph （TEG） indexes and serological indexes in patients with aeute cerebral infarction （ACI）. Methods： A total of 116 ACI patients treated in our hospital were se- lected as ACI group, another 98 cases without ACI, who underwent routine physical examination were regarded as healthy control group. According to severity of neurological function defect during acute phase, ACI group was fur- ther divided into mild ACI group （n= 51）, moderate ACI group （n= 32） and severe ACI group （n= 33）. TEG inde- xes and serum indexes of platelet activation were measured and compared among above group, and the correlation a- mong TEG indexes and serum levels of platelet activation indexes were analyzed. Results： Compared with healthy control group, there were significant reductions in R value [ （6. 17±1.38） min vs. （5. 26 ± 0. 77） rain] and K value [ （2. 39 ± 0.53） rain vs. （1.71 ± 0.58） mini, significant rise in a angle E （63.27 ± 9.23） deg vs. （77.45 ± 12.08） deg], MA value [- （55.09 ± 6.38） mm vs. （77. 13 ± 13.25） mm] of TEG] clot index [CI, （1.68 ± 0. 53） vs. （2.56 ± 0.87）], D - dimer level [. （0. 24 ± 0.07） mg/L vs. （0.38 ± 0. 09） mg/L-] and platelet aggregation rate [PAR, （56. 12 ± 6.75）% vs. （69.17± 9.33）%] in ACI group after treatment, P〈0. 05 all. Among ACI subgroups with different severity, the more severe neurological function defect was, the lower R and K values were, the higher a angle, MA value, CI, D- dimer level and PAR were, there were significant difference in pairwise comparisons （P〈0. 05 or〈0. 01）. Linear regression analysis indicated that PAR was significant inversely correlated with R （B = - 2. 254） and K values （B= -2. 286）, and significant positively correlated with a angle （B= 2. 536）, MA （B= 2. 537） and CI （B= 2. 352）, P〈0.05 or 〈0.01 D - dimer level was significant inversely correlated with R （B = - 2. 276） and K val- ues （B= - 2. 259）, and significant positively correlated with a angle （B = 2. 621）, MA （B = 2. 462） and CI （B = 2. 647）, P〈0.05 or〈0.01. Conclusion： TEG indexes are significantly correlated with platelet activity in ACI pa- tients. TEG possesses good practical value in diagnosis, severity judgment and therapeutic guidance for these pa- tients.
出处
《心血管康复医学杂志》
CAS
2016年第1期101-104,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
脑梗死
血栓弹力描记术
血小板聚集
Brain infarction
Thrombelastography
Platelet aggregation
