Thromboelastography combined with conventional coagulation indices in the detection of endogenous heparin in pa-tients with epidemic hemorrhagic fever
Objective To detect endogenous heparin substance in patients with epidemic haemorrhagic fever(EHF)u-sing thromboelastography(TEG)combined with conventional coagulation indices(CCTs),explore the value of TEG com-bined with CCTs in detecting coagulation function abnormalities in such patients,aiming at providing guidance for clinical treatment.Methods APTT,TT,TEG plain cup R value and TEG heparinase cup R value were tested in 35 EHF patients of mild/moderate stage,severe stage and recovery stage.Intergroup differences were analysed using Friedman ANOVA.Re-sults The mean R and heparin cup R values were 7.5 and 6.7 for mild cases of EHF,and TT,R and heparinase cup R values were 16.9,6.2 and 6.1 for recovering cases,respectively.The normal cup R and heparinase cup R values for mild ca-ses,as well as the TT,R and heparinase cup R values for recovering cases,were normally distributed,and the rest were non-normally distributed.Changes in APTT and TT in EHF patients at different stages were significantly different(P<0.05).The patients'TEG R-values(coagulation reaction time)also showed statistically significant differences in mild-mod-erate,severe and recovery periods(P<0.05).Prolonged APTT,TT and R values in the severe phase compared to the mild-moderate phase indicated that the patient's coagulation function continued to decrease.The difference of R-values minus the heparanase cup R-values in EHF patients was statistically significant in the mild-moderate,severe,and recovery phases(P<0.05).Residual accumulation of endogenous heparin-like substances was higher in the severe phase than in the mild-mod-erate and recovery phases.Conclusion Patients with EHF exhibit significant differences in the values of APTT,TT and R at different stages of the disease.The combined detection using TEG and CCTs indicates that the accumulation of endogenous heparin-like substances is one of the most important causes of coagulation disorders in patients with EHF.The combination of TEG and CCTs can detect the accumulation of endogenous heparin-like substances in patients with EHF,which can provide a laboratory basis for clinicians to adopt targeted therapeutic regimen.
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