Thromboelasto Graphy-Platelet Mapping Parameters,Platelet Agglutination Function and Their Relationship in Patients with Coronary Atherosclerosis and Acute Cerebral Infarction
Objective To analyze the parameters of thromboelasto graphy-platelet mapping(TEG-PM),platelet agglutination function and their relationship in patients with coronary artery atherosclerosis(CAA)and acute cerebral infarction(ACI).Methods A total of 73 patients with CAA and 66 patients with ACI admitted to Tongji Hospital,Tongji Medical College of HUST from 2020-01-01 to 2022-01-01 were enrolled as CAA group and ACI group respectively.A total of 52 individuals who underwent physical examination in the physical examination center of Tongji Hospital,Tongji Medical College of HUST were selected as the control group.According to the severity of the disease,patients in CAA group were further divided into class Ⅰsubgroup(no significant coronary artery stenosis,n=20),class Ⅱ subgroup(coronary artery stenosis 40％-69％,n=19),classⅢ subgroup(coronary artery stenosis 70％-99％,n=20)and class Ⅳ subgroup(complete coronary artery occlusion,n=14),patients in ACI group were further divided into mild subgroup[National Institutes of Health Stroke Scale(NIHSS)score of 1-4,n=35],moderate subgroup(NIHSS score of 5-15,n=15),and severe subgroup(NIHSS score ≥ 16,n=16).TEG-PM parameters[coagulation reaction time(R),formation time of blood cell agglutination block(K),formation rate of blood cell aggregates(α angle),maximum amplitude(MA),arachidonic acid(AA)pathway inhibition rate,adenosine diphosphate(ADP)pathway inhibition rate]and platelet agglutination rate were compared between CAA group and control group,between ACI group and control group,among CAA and ACI patients with different disease severity.Pearson correlation analysis was used to investigate the correlation between TEG-PM parameters and platelet agglutination rate in CAA and ACI patients.Results R and K in CAA group and ACI group were shorter than those in control group,α angle and MA were larger than those in control group,inhibition rate of AA pathway and ADP pathway was lower than that in control group,and platelet agglutination rate was higher than that in control group(P＜0.05).The results of Pearson correlation analysis showed that the R,K,and inhibition rates of AA pathway and ADP pathway in CAA group and ACI group were negatively correlated with platelet agglutination rate,while α angle and MA were positively correlated with platelet agglutination rate(P＜0.05).R of class Ⅱ,Ⅲ and Ⅳ subgroups was shorter than that of class Ⅰ subgroup,R of class Ⅲ and Ⅳ subgroups was shorter than that of class Ⅱ subgroup,and R of class Ⅳ subgroup was shorter than that of class Ⅲ subgroup(P＜0.05).K in class Ⅲ and Ⅳ subgroups was shorter than that in class Ⅰ subgroup,K in class Ⅳ subgroup was shorter than that in class Ⅱ subgroup(P＜0.05).MA in class Ⅲ and Ⅳ subgroups was larger than that in class Ⅰ subgroup,MA in class Ⅲ subgroup was larger than that in class Ⅱ subgroup(P＜0.05).The inhibition rate of AA pathway in class Ⅱ,Ⅲ and Ⅳ subgroups was lower than that in class Ⅰ subgroup,and that in class Ⅳ subgroup was lower than that in class Ⅱ and Ⅲ subgroups(P＜0.05).The inhibition rate of ADP pathway in class Ⅱ,Ⅲ and Ⅳ subgroups was lower than that in class Ⅰ subgroup,and that in class Ⅲ and Ⅳ subgroups was lower than that in class Ⅱ subgroup(P＜0.05).The platelet agglutination rate of class Ⅲ and Ⅳ subgroups was higher than that of class Ⅰ subgroup,and that of class Ⅳ subgroup was higher than that of class Ⅱ subgroup(P＜0.05).R of moderate and severe subgroups was shorter than that of mild subgroup,and that of severe subgroup was shorter than that of mild subgroup(P＜0.05).K in severe subgroup was shorter than that in mild and moderate subgroups,MA was larger than that in mild and moderate subgroups(P＜0.05).The inhibition rates of AA pathway and ADP pathway in moderate and severe subgroups were lower than those in mild subgroup,and those in severe subgroup were lower than those in moderate subgroup(P＜0.05).The platelet agglutination rate in moderate and severe subgroups was higher than that in mild subgroup(P＜0.05).Conclusion In CAA and ACI patients,R and K in TEG-PM parameters are shortened,α angle and MA are increased,and inhibition rates of AA pathway and ADP pathway are decreased,and platelet agglutination function is enhanced.In addition,R,K,and inhibition rates of AA pathway and ADP pathway in TEG-PM parameters of CAA and ACI patients are negatively correlated with platelet agglutination function,while α angle and MA are positively correlated with platelet agglutination function.
Coronary artery diseaseCoronary atherosclerosisBrain infarctionThromboelasto graphy-platelet mappingPlatelet aggregation function
万方数据
维普
