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血栓弹力图联合抗凝检测在 60 岁以上心血管或脑血管病患者中的价值。

Value of thromboelastography combined with anticoagulant detection in patients over 60 years of age with cardiovascular or cerebrovascular disease.

机构信息

Department of Clinical Laboratory, the Second Hospital of Jilin University, Changchun, China.

出版信息

Ann Palliat Med. 2021 May;10(5):5407-5416. doi: 10.21037/apm-21-822. Epub 2021 May 13.

Abstract

BACKGROUND

Cardiovascular disease (CVD) and cerebrovascular disease (CBVD) are common diseases in middle-aged and elderly people with high morbidity, mortality and disability rates. Individualized assessment and treatment are helpful to improve the quality of life and prognosis of patients. Thrombelastography (TEG) is a method to evaluate the coagulation function of patient with whole blood. In this study, we investigated the correlation between TEG indicators and traditional indicators of coagulation, and evaluated the diagnostic value of TEG combined with indicators of coagulation in elderly patients with CVD and CBVD.

METHODS

We retrospectively analyzed the thrombelastographic indices and traditional indicators of coagulation in 285 cases of elderly patients with CBVD or CVD. All measures were performed by the Department of Clinical Laboratory in the Second Hospital of Jilin University between January 2016 and December 2018.

RESULTS

Compared with the control group, the platelet count, mean platelet volume (MPV), and APTT were increased in the CBVD group. K value, MPV, and the MPV/PLT ratio were higher, but fibrinogen levels and the PT were lower in the CVD group than in the control group. In the CVD and CBVD groups, the R value was positively correlated with APTT, the K value was negatively correlated with fibrinogen, α angle was positively correlated with fibrinogen, and the MA was positively correlated with the platelet count and fibrinogen, but negatively correlated with MPV/PLT. The FDP was significantly higher, whereas the D-dimer/FDP ratio was lower in the CBVD group than in the CVD group.

CONCLUSIONS

The combined detection of TEG and traditional indicators is more effective than detection using only routine indices in the assessment of the coagulation status of elderly patients with CVD or CBVD. The MPV/PLT and D-dimer/FDP ratios can be used as indices of anticoagulant function.

摘要

背景

心脑血管疾病(CVD)和脑血管疾病(CBVD)是中老年人的常见疾病,具有较高的发病率、死亡率和致残率。个体化评估和治疗有助于提高患者的生活质量和预后。血栓弹力图(TEG)是一种评估全血凝血功能的方法。本研究旨在探讨 TEG 指标与传统凝血指标的相关性,并评估 TEG 联合凝血指标对老年 CVD 和 CBVD 患者的诊断价值。

方法

回顾性分析 2016 年 1 月至 2018 年 12 月吉林大学第二医院临床检验科 285 例老年 CBVD 或 CVD 患者的血栓弹力图指标和传统凝血指标。

结果

与对照组相比,CBVD 组血小板计数、平均血小板体积(MPV)和 APTT 升高,K 值、MPV 和 MPV/PLT 比值升高,而纤维蛋白原水平和 PT 降低。在 CVD 和 CBVD 组中,R 值与 APTT 呈正相关,K 值与纤维蛋白原呈负相关,α角与纤维蛋白原呈正相关,MA 与血小板计数和纤维蛋白原呈正相关,与 MPV/PLT 呈负相关。CBVD 组 FDP 明显升高,D-二聚体/FDP 比值降低。

结论

TEG 与传统指标联合检测比单独检测常规指标更能有效评估老年 CVD 或 CBVD 患者的凝血状态。MPV/PLT 和 D-二聚体/FDP 比值可作为抗凝功能的指标。

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