上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (4): 459-.doi: 10.3969/j.issn.1674-8115.2013.04.016

• 论著（临床研究） • 上一篇    下一篇

急性脑梗死患者血栓弹力图与血小板聚集率和D-二聚体相关性研究

周熙琳1,2, 梁 辉1,2, 黄洁杰1   

  1. 上海交通大学 |医学院附属新华医院 1.血液科, 上海 200092； 2.崇明分院老年科, 上海 202150
  • 出版日期:2013-04-28 发布日期:2013-05-03
  • 通讯作者: 梁 辉, 电子信箱: lianghuiwu@sina.com。
  • 作者简介:周熙琳（1972—）, 女, 主治医师, 学士； 电子信箱: zhou2xilin@163.com。
  • 基金资助:

    崇明县科委基金（CK-2011-31）

Correlation of thrombelastogram with platelet aggregation rate and D-dimer in patients with acute cerebral infarction

ZHOU Xi-lin1,2, LIANG Hui1,2, HUANG Jie-jie1   

  1. 1.Department of Hematology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China； 2.Department of Geriatrics, Chongming Branch of Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 202150, China
  • Online:2013-04-28 Published:2013-05-03
  • Supported by:

    Chongming County Science and Technology Committee Foundation, CK-2011-31

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摘要：

目的 探讨急性脑梗死患者血栓弹力图（TEG）各项参数与血小板聚集率（PAgT）和D-二聚体之间的相关性。方法 选取102例急性脑梗死患者，根据神经功能缺损程度评分标准分为轻度急性脑梗死组（n=41）、中度急性脑梗死组（n=35）和重度急性脑梗死组（n=26）；并以50名健康体检者为对照组。所有研究对象均进行TEG参数（包括R值、K值、α角、MA值、CI值）、PAgT和D-二聚体水平检测。结果 与正常对照组比较，急性脑梗死组患者的R值和K值明显缩短，α角、MA值和CI值明显增大，D-二聚体和PAgT水平明显升高，差异均有统计学意义（P<001）。与中度和轻度脑梗死组比较，重度脑梗死组患者的TEG参数、D-二聚体及PAgT水平差异均有统计学意义（P<0.05）；与轻度脑梗死组比较，中度脑梗死组TEG参数和PAgT水平差异也有统计学意义（P<005），但D-二聚体水平差异无统计学意义（P>0.05）。Pearson相关性分析显示，D-二聚体和PAgT水平与α角、MA值、CI值呈显著正相关，与R值和K值呈显著负相关（均P<0.01）。结论 急性脑梗死患者TEG参数与D-二聚体和PAgT水平存在较强的相关性，TEG在急性脑梗死的诊断、严重程度评价以及高凝状态监测中均具有良好的实用价值。

关键词: 急性脑梗死, 血栓弹力图, 血小板聚集率, D-二聚体

Abstract:

Objective To investigate the correlation of parameters of thrombelastogram (TEG) with platelet aggregation rate (PAgT) and D-dimer in patients with acute cerebral infarction. Methods One hundred and two patients with acute cerebral infarction were selected, and were divided into mild acute cerebral infarction group (n=41), moderate acute cerebral infarction group (n=35) and severe acute cerebral infarction group (n=26) according to the scores of severity of neurological deficit. Besides, 50 healthy subjects were served as control group. All subjects were examined with the parameters of TEG (including R value, K value, α angle, MA value and CI value), PAgT and D-dimer. Results R-value and K value were significantly smaller, α angle, MA value and CI value were significantly larger and the D-dimer and PAgT levels were significantly higher in patients with acute cerebral infarction than in control group (P<0.01). The parameters of TEG and levels of PAgT and D-dimer in severe acute cerebral infarction group were significantly different from those in mild acute cerebral infarction group and moderate acute cerebral infarction group (P<0.05). The parameters of TEG and PAgT level in moderate acute cerebral infarction group were significantly different from those in mild acute cerebral infarction group (P<0.05), while there was no significant difference in D-dimer level between these two groups (P＞0.05). Pearson correlation analysis revealed that the D-dimer and PAgT levels were positively related to α angle, MA value and CI level (P<0.01), and were negatively related to R-value and K value (P<0.01). Conclusion The parameters of TEG are significantly related to the D-dimer and PAgT levels in patients with acute cerebral infarction. TEG plays a role in the diagnosis of acute cerebral infarction, evaluation of severity of acute cerebral infarction and monitoring of hypercoagulable state.

Key words: acute cerebral infraction, thrombelastograph, platelet aggregation rate, D-dimer