血栓弹力图在预测白血病患者出血风险中的作用。

The role of thromboelastography in predicting hemorrhage risk in patients with leukemia.

作者信息

Bao Hang-Xing, Du Jing, Chen Bing-Yu, Wang Ying

机构信息

Zhejiang Provincial Hospital of TCM, First Clinical Medical College of Zhejiang Chinese Medical University Department of Transfusion Medicine Department of Laboratory Medicine, Zhejiang Provincial People's Hospital of Hangzhou Medical College, Hangzhou, China.

出版信息

Medicine (Baltimore). 2018 Mar;97(13):e0137. doi: 10.1097/MD.0000000000010137.

DOI:10.1097/MD.0000000000010137

PMID:29595638

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5895378/

Abstract

This study aimed to compare the efficacy of thromboelastography (TEG) and conventional coagulation methods in predicting hemorrhage risk in patients with leukemia.A total of 226 patients diagnosed with leukemia were included and divided into bleeding and nonbleeding groups. All patients had their blood samples taken for TEG test to measure the reaction time (R time), alpha (α angle), and maximum amplitude (MA) as well as measure platelet count (PLT), prothrombin time, and activated partial thromboplastin time. Patients were followed up for bleeding episodes.The multivariate analysis showed that PLT [odds ratio (OR) = 0.993] and MA (OR = 0.921) have better association with bleeding risk. Receiver operating characteristic (ROC) analysis showed that the combination of PLT and MA (AUC = 0.824) was better for hemorrhage risk prediction than PLT [area under the curve (AUC) = 0.730] and MA (AUC = 0.819) alone.The combination of TEG and conventional coagulation methods could help in assessing the risk of hemorrhage in patients with leukemia.

摘要

本研究旨在比较血栓弹力图（TEG）与传统凝血方法在预测白血病患者出血风险方面的疗效。共纳入226例确诊为白血病的患者，并分为出血组和非出血组。所有患者均采集血样进行TEG检测，以测量反应时间（R时间）、α角和最大振幅（MA），并检测血小板计数（PLT）、凝血酶原时间和活化部分凝血活酶时间。对患者进行出血事件随访。多因素分析显示，PLT[比值比（OR）=0.993]和MA（OR=0.921）与出血风险的相关性更好。受试者工作特征（ROC）分析表明，PLT和MA联合检测（曲线下面积[AUC]=0.824）在预测出血风险方面优于单独检测PLT（曲线下面积[AUC]=0.730）和MA（AUC=0.819）。TEG与传统凝血方法联合应用有助于评估白血病患者的出血风险。