Alvarado-Ramos S, López-Gutiérrez M R, Nuñez-Alvar R D
Medical Center of High Specialty Gynecology and Obstetrics No. 23, Mexican Social Security Institute, Monterrey, Nuevo León, Mexico.
School of Medicine and Health Sciences, Technological Institute and Higher Studies of Monterrey, Monterrey, Nuevo León, Mexico.
Anesthesiol Res Pract. 2025 Mar 6;2025:8871619. doi: 10.1155/anrp/8871619. eCollection 2025.
This prospective, descriptive, cross-sectional study aimed to establish kaolin-based thromboelastography reference values for previously known healthy third-trimester pregnancy patients. The study included 280 patients aged 18-38 years who were admitted to labor or scheduled for elective c-sections. Blood specimens collected via IV catheters were immediately mixed with reagents, placed in coagulation cups, and subjected to 60 min of testing at 37°C using a Haemonetics TEG 5000 system. The Hoffman regression method calculated the reference values; furthermore, effect size determination was done using Cohen's for comparison of data from other sources. Patients had a median age of 26 (IQR 22-31), and their thromboelastography profile exhibited reference values for: time (1-7 min), clot kinetics (1-2), angle (59°-82°), maximum amplitude (60-86 mm), and clot lysis at both 30 min (0%-6%) and 60 min (0%-8%). Results revealed significant differences in various thromboelastography parameters when comparing local patient cohorts against published reports, mainly European and North American counterparts. Shorter reaction times, enhanced clot kinetics, larger angles, and higher maximum amplitude, curve amplitude at 30 min, and amplitude at 60 min indicated distinct coagulation profiles and behaviors in the northeastern region of Mexico. Reference values for the Northern region of Mexico have been calculated and are characterized by a shorter clot reaction time, faster clot dynamics, higher angle values, overall greater curve amplitude, and no differences in enzymatic lysis activity compared to samples from other geographic regions.
这项前瞻性、描述性横断面研究旨在为已知健康的孕晚期患者建立基于高岭土的血栓弹力图参考值。该研究纳入了280名年龄在18至38岁之间、因分娩入院或计划进行择期剖宫产的患者。通过静脉导管采集的血样立即与试剂混合，放入凝血杯中，并使用Hemotec TEG 5000系统在37°C下进行60分钟的检测。采用霍夫曼回归方法计算参考值；此外，使用科恩效应量来确定效应大小，以便与其他来源的数据进行比较。患者的中位年龄为26岁（四分位间距为22至31岁），他们的血栓弹力图特征显示出以下参考值：反应时间（1至7分钟）、凝血动力学（1至2）、角度（59°至82°）、最大振幅（60至86毫米），以及30分钟时的凝块溶解率（0%至6%）和60分钟时的凝块溶解率（0%至8%）。结果显示，将当地患者队列与已发表的报告（主要是欧洲和北美的报告）进行比较时，各种血栓弹力图参数存在显著差异。较短的反应时间、增强的凝血动力学、更大的角度以及更高的最大振幅、30分钟时的曲线振幅和60分钟时的振幅表明墨西哥东北部地区具有独特的凝血特征和行为。已计算出墨西哥北部地区的参考值，其特点是凝血反应时间较短、凝血动态较快、角度值较高、总体曲线振幅更大，并且与其他地理区域的样本相比，酶解活性没有差异。
