Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of Clinical Laboratory, Yi Yang Central Hospital, Yiyang, Hunan, China.
Int J Lab Hematol. 2018 Aug;40(4):459-465. doi: 10.1111/ijlh.12827. Epub 2018 Apr 30.
Congenital dysfibrinogenaemia (CD) is a rare hereditary blood disorder, and thromboelastography (TEG) can comprehensively assess the clotting function of patients. However, only few studies have focussed on the application of TEG in CD. We aim to investigate the clinical value of TEG in congenital CD.
We performed TEG and routine coagulation tests, including plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), functional fibrinogen (Fg) concentration (Clauss method) and Fg concentration (PT-derived method) tests, in 17 patients with CD (experimental group) and 28 healthy individuals (control group).
In the TEG test, the coagulation time was significantly longer and the angle value was significantly smaller in the experimental group than that in the control group (3.73 ± 1.73 minutes vs 1.99 ± 0.49 minutes; 52.39°±11.6° vs 65.69°±4.43°; P < .05 for both); the coagulation index was significantly decreased in the experimental group when compared to the control group (-0.86 ± 2.85 vs 1.29 ± 1.53) (P < .05), but the maximum amplitude was not significantly different (P > .05). In the coagulation test, compared with the control group, TT was significantly longer (11.59 ± 0.93 minutes vs 32.34 ± 7.1 minutes; P < .05) and the functional Fg concentration was significantly lower (3.17 ± 0.59 g/L vs 0.56 ± 0.18 g/L; P < .05) in the experimental group, whereas there were no differences in APTT, PT and Fg concentrations (P > .05).
TEG is highly accurate for detecting coagulation function in patients with CD, with the thromboelastographic coagulation time and angle reflecting a reduced Fg activity, thereby facilitating diagnosis and differential diagnosis of CD and coagulation status evaluation of patients with CD.
先天性纤维蛋白原血症（CD）是一种罕见的遗传性血液疾病，血栓弹性描记术（TEG）可全面评估患者的凝血功能。然而，仅有少数研究关注 TEG 在 CD 中的应用。本研究旨在探讨 TEG 在先天性 CD 中的临床价值。
我们对 17 例 CD 患者（实验组）和 28 名健康个体（对照组）进行了 TEG 和常规凝血检测，包括血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、功能性纤维蛋白原（Clauss 法）浓度和纤维蛋白原浓度（PT 衍生法）检测。
在 TEG 检测中，实验组的凝血时间明显长于对照组，角度值明显小于对照组（3.73±1.73 分钟比 1.99±0.49 分钟；52.39°±11.6°比 65.69°±4.43°；均 P<.05）；实验组的凝血指数明显低于对照组（-0.86±2.85 比 1.29±1.53）（P<.05），但最大振幅无明显差异（P>.05）。在凝血检测中，与对照组相比，实验组 TT 明显延长（11.59±0.93 分钟比 32.34±7.1 分钟；P<.05），功能性纤维蛋白原浓度明显降低（3.17±0.59 克/升比 0.56±0.18 克/升；P<.05），而 APTT、PT 和纤维蛋白原浓度无差异（P>.05）。
TEG 对检测 CD 患者的凝血功能具有高度准确性，血栓弹性图凝血时间和角度反映纤维蛋白原活性降低，有助于 CD 的诊断和鉴别诊断以及 CD 患者凝血状态的评估。
