|
|
Clinical Value of Thromboelastography in Acute Cerebrovascular Disease Patients |
WEI Xiao-qiang, LI Dan-jie |
Department of Blood Transfusion, Shanghai Changhai Hospital 200434 |
|
|
Abstract 【Objective】To explore the changes and clinical value of thromboelastography in acute cerebrovascular disease patients. 【Methods】A total of 146 patients with acute cerebrovascular disease (73 patients with acute cerebral hemorrhage and 73 patients with acute cerebral infarction) treated in our hospital were collected in this study. All of them received CT scanning after admission to evaluate the volume of cerebral hemorrhage and area of cerebral infarction. Venous bloods were collected to detect level of TEG [coagulation reaction time (R), blood formation time (K), angle, maximum amplitude (MA) and coagulation index (CI)] to compare the difference between two groups and analyze the relationship of TEG indexes with the amount of cerebral hemorrhage and area of cerebral infarction. Meanwhile, the value of TEG to distinguish the two types of acute cerebrovascular disease was identified by using receiver operating characteristic (ROC) curve. 【Results】 (1) the K time and R time of the cerebral hemorrhage group were higher than those of the cerebral infarction group, while angle and CI levels were lower than those in the cerebral infarction group (P<0.01). (2) Compared to cerebral hemorrhage 30 mL, patients with cerebral hemorrhage 30 mL had shorter K time, while they had higher value of MA and angle; Compared to patients with small and medium-sized cerebral infarction, patients with large-area cerebral infarction had lower R time and higher value of MA and angle (P<0.01). (3) The ROC curve found that the value of K-time, R-time, angle and CI for diagnosis of cerebral hemorrhage were 0.73(0.64-0.81), 0.82(0.75-0.89), 0.76(0.68-0.84) and 0.65 (0.60-0.74),respectively; and all p values were less than 0.05. 【Conclusion】The level of TEG in acute cerebral hemorrhage and acute cerebral infarction was significantly different. It can be used as an index to identify acute cerebral hemorrhage and infarction, which had a relationship with the status of acute cerebrovascular disease.
|
Received: 04 November 2020
|
|
|
|
|
[1] 尹晓刚. 脑出血与脑梗死患者血栓弹力实验指标变化的研究[J].中国实用神经疾病杂志,2017,20(2):31-34.
[2] WIKKELSØ A,WETTERSLEV J,MØLLER AM,et al. Thromboelastography (TEG) or rotational thromboelastometry (ROTEM) to monitor haemostatic treatment in bleeding patients: a systematic review with meta-analysis and trial sequential analysis [J].Anaesthesia,2017,72(4):519-531.
[3] 刘磊,郑山根. 血栓弹力图监测肝衰竭患者凝血功能的临床研究进展[J].解放军预防医学杂志,2019,37(3):187-189.
[4] 赵雪,吕高友. 血栓性疾病中血栓弹力图的应用进展[J].海南医学,2017,28(13):2161-2163.
[5] 中华医学会神经病学分会,中华医学会神经病学分会. 脑血管病学组中国脑出血诊治指南(2019)[J].中华神经科杂志,2019,52(12):994-1005.
[6] 中华医学会神经病学分会,中华医学会神经病学分会. 脑血管病学组中国急性缺血性脑卒中诊治指南(2014)[J].中华神经科杂志,2015,48(4):246-257.
[7] 王明,胡孝锋,李聘,等. 老年高血压性脑出血患者预后情况与CT影像诊断特征的相关性研究[J].老年医学与保健,2019,25(4):537-541.
[8] 杨静,戴骏,董海蓉,等. 中性粒-淋巴细胞比值对急性脑梗死面积的预测研究[J].卒中与神经疾病,2019,26(5):607-610.
[9] 万学红,卢雪峰. 止血与血栓检测//陈文彬. 诊断学[M]. 第8版,北京:人民卫生出版社,2014:285-308.
[10] 位坤坤,廖祖宁,张红梅. 血栓弹力图在脑血管疾病中的应用研究进展[J].临床神经病学杂志,2018,31(1):71-72.
[11] 王全懂, 秦佩媛, 李松, 等. 应用血栓弹力图预测短暂性脑缺血发作 患者进展为脑梗死的临床研究[J].中国老年心脑血管病杂志, 2015, 17(12): 1292-1294. |
|
|
|