Changes and clinical significance of thromboelastogram parameters in patients with hypertensive cerebral hemorrhage
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维普
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目的 探讨高血压脑出血(HCH)患者血栓弹力图(TEG)参数变化及其临床意义.方法 选取2019年 1月至2022年3月舟山医院收治的81例HCH患者为HCH组,同期收治的80例脑梗死患者为脑梗死组,同期健康体检的80名志愿者为对照组.比较3组研究对象以及不同脑出血量的HCH患者TEG参数[主要包括凝血反应时间(R)、凝血形成时间(K)、α角度(Angle)、血栓形成最大振幅(MA)、凝血综合指数(CI)],采用ROC曲线分析TEG参数鉴别诊断HCH与脑梗死的效能.结果 3 组研究对象R比较,差异无统计学意义(P=0.130).HCH组K明显高于脑梗死组和对照组(均P＜0.05),Angle、MA、CI均明显低于脑梗死组和对照组(均P＜0.05),脑梗死组与对照组K、Angle、MA、CI比较差异均无统计学意义(均P＞0.05).HCH组患者中,出血量＜30 mL 38例,≥30 mL 43例;与脑出血量＜30 mL患者比较,≥30 mL患者K明显较高(P＜0.001),Angle、MA、CI均明显较低(均P＜0.01).K、Angle、MA、CI鉴别诊断HCH与脑梗死的AUC分别为 0.829、0.771、0.761、0.788.结论 HCH患者TEG参数较脑梗死或正常人群存在明显差异,K增高而AngIe、MA、CI降低,且出血量大者更明显.
Objective To investigate the changes and clinical significance of thromboelastogram(TEG)parameters in patients with hypertensive cerebral hemorrhage(HCH).Methods Eighty-one patients with HCH admitted to Zhoushan Hospital from January 2019 to March 2022 were selected as HCH group,meanwhile 80 patients with cerebral infarction(CBI)and 80 healthy volunteers were selected as CBI group and control group,respectively.TEG parameters including coagulation reaction time(R),coagulation formation time(K),α angle(Angle),maximum thrombosis amplitude(MA),and coagulation composite index(CI)were compared between three groups and HCH patients with different cerebral hemorrhage volume.ROC curve was used to analyze the efficacy of TEG parameters in the differential diagnosis of HCH and CBI.Results There was no significant difference in R among the three groups(P＞0.05).K of HCH group was significantly higher than that of CBI group and control group(all P＜0.05),Angle,MA and CI were significantly lower than those of CBI group and control group(all P＜0.05).K,Angle,MA and CI were not significantly different between CBI group and control group(all P＞0.05).In HCH group,38 cases had hemorrhage volume＜30 mL and 43 cases had hemorrhage volume≥30 mL.K was significantly higher(P＜0.001),while Angle,MA and CI were significantly lower(all P＜0.01),in patients with cerebral hemorrhage≥30 mL than in patients with cerebral hemorrhage＜30 mL.The AUC of K,Angle,MA and CI for differential diagnosis of HCH and CBI were 0.829,0.771,0.761 and 0.788,respectively.Conclusion The TEG parameters of HCH patients were significantly different from those of CBI or normal population,K increases,Angle,MA and CI decrease.The changes are more significant in patients with more cerebral hemorrhage.
维普
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