实用医学杂志 ›› 2022, Vol. 38 ›› Issue (5): 606-610.doi: 10.3969/j.issn.1006⁃5725.2022.05.016

• 临床研究 • 上一篇    下一篇

血栓弹力图与传统凝血功能检测的相关性与一致性分析

何嘉豪 江倩 刘春丽   

  1. 广州医科大学附属第一医院,广州呼吸健康研究院,国家呼吸医学中心(广州510000)

  • 出版日期:2022-03-10 发布日期:2022-03-10
  • 通讯作者: 刘春丽 E⁃mail:chunli@gird.cn
  • 基金资助:
    科技部国家重点研发计划子课题(编号:2016YFC1304102)

Analysis of the correlation and consistency between thromboelastography and traditional coagulation tests

HE Jiahao,JIANG Qian,LIU Chunli.   

  1. The First Affiliated Hospital of Guangzhou Medical University,Guangzhou Institute of Respiratory Health,National Center for Respiratory Medicine,Guangzhou 510000,China

  • Online:2022-03-10 Published:2022-03-10
  • Contact: LIU Chunli E⁃mail:chunli@gird.cn

摘要:

目的 探讨普通住院患者中血栓弹力图(TEG)与传统凝血功能检测指标的相关性与一致性。 方法 回顾性分析 2018 1 月至 2020 12 月本中心符合入排标准并且行 TEG 检查的住院患者 886 例,采集血小板计数、凝血功能检测指标和血栓弹力图数据,对两种检测方法的相关性与一致性进行分析。 结果 A 值与血小板(PLT)、D⁃二聚体、纤维蛋白原(FIB)有显著相关性,其中与 FIB 相关性最强(r = 0.486,P < 0.001);CI PLT、D⁃二聚体、PT、FIB、APTT、TT有显著相关性,其中与FIB相关性最强(r = 0.362 P < 0.001);MA PLT、D⁃二聚体、PT、FIB、APTT 有显著相关性,其中与 FIB 相关性最强(r = 0.380,P < 0.001);Angle PLT、D⁃二聚体、FIB、APTT 有显著相关性,其中与 FIB 相关性最强(r = 0.380,P < 0.001); PLT 与D⁃二聚体、K、Angle、MA、CI、A有显著相关性,其中与MA 值相关性最强(r = 0.483,P < 0.001)。评估 高凝状态时,PT与PLT、R⁃time、K、MA具有一致性,PLT与K、Angle、CI具有一致性,FIB与PLT、K、Angle、MA 具有一致性,APTT与PLT、K、MA、CI具有一致性;在评估低凝状态时,FIB与PLT、K、Angle、MA、CI具有一致 性,PLT R⁃time、K、Angle、MA、CI 具有一致性。其他指标间的一致性差异无统计学意义。结论 在普通住院患者中血栓力图与传统凝血功能检测间存在一定的相关性,但对血液低凝或高凝状态的判断一致性 较差。由于TEG反映凝血与纤溶过程更全面,但传统凝血检测对血液轻微变化更敏感,因此两种测试方法 可联合使用,以提供更全面的凝血情况。

关键词:

血栓弹力图, 凝血功能检测, 相关性, 一致性

Abstract:

Objective To explore the correlation and consistency between the thromboelastogram and traditional coagulation tests in ordinary hospitalized patients. Method A retrospective review of 886 inpatients in our center who met the admission criteria and underwent thrombelastography(TEG)examinations between January 2018 and December 2020. Collecting platelet count,coagulation tests and thromboelastogram,and analyzing the correlation and consistency of the two detection methods. Result A value is significantly correlated with PLT,D⁃ dimer,FIB,among which is the strongest correlation with FIB(r = 0.486,P < 0.001);CI has significant correlation with PLT,D⁃dimer,PT,FIB,APTT,TT ,Among which the correlation with FIB is the strongest(r = 0.362,P < 0.001);G has significant correlation with PLT and FIB,among which the correlation with FIB is the strongest (r = 0.181,P < 0.001);MA has the strongest correlation with PLT,D⁃dimer,PT,FIB,APTT have significant correlation,of which the correlation with FIB is the strongest(r = 0.380,P < 0.001);Angle has a significant correlation with PLT,D⁃dimer,FIB,APTT,and the correlation with FIB is the strongest(r = 0.380,P < 0.001); K value has significant correlation with PLT,D⁃dimer,PT,FIB,APTT,among which the correlation with FIB is the strongest(r = -0.251,P < 0.001);D⁃dimer and PLT ,K,Angle,MA,CI,A have significant correlations among which the correlation with MA value is the strongest(r = 0.163,P < 0.001);PLT has significant correlation with D⁃dimer,K,Angle,MA,CI,A Among them,the correlation with the MA value has the strongest(r = 0.483 P < 0.001). When assessing hypercoagulability status,PT is consistent with PLT,R⁃time,K,and MA,PLT is consistent with K,Angle,and CI,FIB is consistent with PLT,K,Angle,and MA,and APTT is consistent with PLT,K,MA,CI;When evaluating hypocoagulation status,FIB is consistent with PLT,K,Angle,MA,and CI,and PLT is consistent with R⁃time,K,Angle,MA,and CI. Other indicators′ consistency was not statistically significant. Conclusion There is a correlation between thrombosis attempts and traditional coagulation tests in ordinary hospi⁃ talized patients,but the consistency of the blood hypocoagulation or hypercoagulation status judgment is poor. TEG more accurately reflects the coagulation and fibrinolysis processes,but coagulation tests are more sensitive to slight chang⁃ es in blood. The two test methods can be used in combination to provide a more comprehensive coagulation situation.

Key words: thromboelastography,  , coagulation tests,  , correlation,  , consistency