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血栓弹力图检测在脑梗死诊断及评估预后中的应用价值

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目的 通过对脑梗死患者的血栓弹力图(TEG)、凝血四项、D-二聚体(D-D)检测结果进行分析,评价TEG检测在脑梗死诊断及评估预后中的应用价值.方法 选取 2020 年 3 月至 2023 年 7 月云浮市人民医院收治的脑梗死患者 100 例和健康体检人员 80 名为研究对象,对两组进行TEG、凝血四项、D-D检测并分析.结果 观察组的凝血反应时间(R)、凝血形成时间(K)低于对照组,最大振幅(MA)、D-D高于对照组,差异均有统计意义(P<0.05).观察组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)与对照组比较差异无统计意义(P>0.05).观察组的重度脑梗亚组的R、K低于轻度脑梗亚组,MA、D-D高于轻度脑梗亚组,差异均有统计意义(P<0.05).重度脑梗亚组的R、K低于中度脑梗亚组,MA、D-D高于中度脑梗亚组,差异均有统计意义(P<0.05).中度脑梗亚组的R、K低于轻度脑梗亚组,MA、D-D高于轻度脑梗亚组,差异均有统计意义(P<0.05).观察组的R与APTT呈正相关(P<0.01),MA与FIB呈正相关(P<0.01),K与FIB呈负相关(P<0.01).结论 相比常规凝血指标,TEG对脑梗死的诊断有重要的临床价值,神经缺血性损伤程度越严重,TEG高凝状态越明显,对脑梗死的预后评估有重要帮助.TEG是脑梗死诊断及预后评估的良好指标,值得在临床上推广应用.
Application value of thromboelastography in diagnosis and prognosis evaluation of cerebral infarction
Objective To analyze the results of thromboelastography(TEG),coagulation and D-D in patients with cerebral infarction,and to evaluate the application value of TEG in the diagnosis and prognosis of cerebral infarction.Methods From March 2020 to July 2023,100 patients with cerebral infarction and 80 healthy individuals who underwent physical examinations at Yunfu People's Hospital were selected as the research subjects.TEG,coagulation,and D-D tests were performed and analyzed on the two groups.Results The coagulation reaction time(R)and clotting time(K)of the observation group were lower than those of the control group,while the maximum amplitude(MA)and D-D were higher than those of the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in prothrombin time(PT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)between the observation group and the control group(P>0.05).The R and K of the severe cerebral infarction subgroup in the observation group were lower than those in the mild cerebral infarction subgroup,while the MA and D-D were higher than those in the mild cerebral infarction subgroup,and the differences were statistically significant(P<0.05).The R and K of the severe cerebral infarction subgroup were lower than those of the moderate cerebral infarction subgroup,while the MA and D-D were higher than those of the moderate cerebral infarction subgroup,and the differences were statistically significant(P<0.05).The R and K of the moderate cerebral infarction subgroup were lower than those of the mild cerebral infarction subgroup,while the MA and D-D were higher than those of the mild cerebral infarction subgroup,and the differences were statistically significant(P<0.05).The R of the observation group was positively correlated with APTT(P<0.01),MA was positively correlated with FIB(P<0.01),and K was negatively correlated with FIB(P<0.01).Conclusion Compared with conventional coagulation indicators,TEG has important clinical value in the diagnosis of cerebral infarction.The more severe the degree of neuroischemic injury,the more obvious the hypercoagulable state of TEG,which is of great help in the prognosis evaluation of cerebral infarction.TEG is a good indicator for the diagnosis and prognosis evaluation of cerebral infarction and it is worth promoting and applying in clinical practice.

ThromboelastographyCerebral infarctionCoagulationPrognosis

陈浩峰、陈德杰、叶伙梅

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广东省云浮市人民医院输血科,广东云浮 527300

血栓弹力图 脑梗死 凝血 预后

2024

中国医药科学
海峡两岸医药卫生交流协会 二十一世纪联合创新(北京)医药科学研究院

中国医药科学

影响因子:1.083
ISSN:2095-0616
年,卷(期):2024.14(17)