张筠

【摘要】 目的：分析急性腦梗死患者血栓弹力图与凝血功能检查的相关性。方法：选取2018年10月-2019年12月本院收治的85例急性脑梗死患者及60例健康体检者为研究对象，急性脑梗死患者列为观察组，健康体检者列为对照组，两组均行血栓弹力图检测，比较两组血栓弹力图参数[凝血反应时间（R）、血细胞凝集块形成时间（K）、血凝块最大强度（MA）、凝血综合指数（CI）、血细胞凝集块形成速率（a角）]与凝血功能四项[D-二聚体（DD）、血浆凝血酶原时间（PT）、部分凝血活酶时间（APTT）、血浆纤维蛋白原（FIB）];同时将血栓弹力图参数与凝血功能四项进行相关性分析。结果：观察组的R与K明显低于对照组，MA与a角明显高于对照组，差异均有统计学意义（P<0.05）;观察组DD与FIB明显高于对照组，差异有统计学意义（P<0.05）;观察组的PT与APTT与对照组比较，差异无统计学意义（P>0.05）;经Person相关性分析，R、K与PT、APTT呈正相关（P<0.05），与DD、FIB呈负相关（P<0.05）;MA、CI、a角与DD、FIB呈正相关（P<0.05），与PT、APTT呈负相关（P<0.05）。结论：急性脑梗死患者的凝血功能存在一定程度上的异常，且血栓弹力图参数与患者的凝血功能具有显著相关性，积极予以急性脑梗死患者行血栓弹力图检测，对患者的诊断及病情评估十分有利。

【关键词】 急性脑梗死 血栓弹力图 凝血功能 相关性

doi：10.14033/j.cnki.cfmr.2020.19.027 文献标识码 B 文章编号 1674-6805（2020）19-00-03

Analysis of the Correlation between Thromboelastography and Coagulation Function in Patients with Acute Cerebral Infarction/ZHANG Yun. //Chinese and Foreign Medical Research， 2020， 18（19）： -70

[Abstract] Objective： To analyze the correlation between thromboelastography and coagulation function in patients with acute cerebral infarction. Method： A total of 85 patients with acute cerebral infarction and 60 health checkups admitted in our hospital from October 2018 to December 2019 were selected as the subjects. The patients with acute cerebral infarction were listed as the observation group and the healthy people as the control group. The two groups were tested by thromboelastography. Comparison of thromboelastogram parameters between two groups [coagulation reaction time （R）， formation time of hemagglutination block （K）， the maximum intensity of blood clot （MA）， coagulation composite index （CI）， formation rate of hemagglutination block （angle a）] and four coagulation functions [D-Dimer （DD）， plasma prothrombin time （PT）， partial thromboplastin time （APTT）， plasma fibrinogen （FIB）]. At the same time， the correlation between thromboelastography parameters and coagulation function was analyzed. Result： R and K in the observation group were significantly lower than those in the control group， and MA and a angles were significantly higher than those in the control group， the differences were statistically significant （P<0.05）. DD and FIB in the observation group were significantly higher than those in the control group， the differences were statistically significant （P<0.05）. PT and APTT in the observation group were compared with those in the control group， there was no significant difference （P>0.05）. According to the person correlation analysis， R and K are positively correlated with PT and APTT （P<0.05）， and negatively correlated with DD and FIB （P<0.05）. MA， CI and a are positively correlated with DD and FIB （P<0.05）， and negatively correlated with PT and APTT （P<0.05）. Conclusion： The coagulation function of patients with acute cerebral infarction is abnormal to some extent， and there is a significant correlation between the parameters of thromboelastogram and the coagulation function of patients.

[Key words] Acute cerebral infarction Thromboelastography Coagulation function Correlation

First-authors address： The Second Hospital of Longyan， Longyan 364000， China

急性脑梗死主要是指因脑部血液供应障碍，导致脑部缺血、缺氧而引发局限性脑组织坏死[1]。该疾病会导致患者的凝血功能紊乱，而凝血功能紊乱会导致患者体内的凝血物质增加，从而造成脑组织微循环障碍，加重患者颅脑损伤[2-3]。由此可见，凝血功能障碍与患者的病情有一定关系，临床需明确患者的凝血功能状况，为临床医师提供科学诊断依据，从而及早实施针对性治疗。血栓弹力图是一种反映人体整个凝血功能动态的图谱，其通过检测分析仪能有效模拟人体的凝血过程，这对明确急性脑梗死患者的凝血功能状态具有重要的意义[4]。故本次研究对2018年10月-2019年12月本院收治的85例急性脑梗死患者及60例健康体检者进行临床分析，旨在分析急性脑梗死患者血栓弹力图与凝血功能检查的相关性，现报告如下。……