血栓弹力图预测老年重症患者血栓发生的敏感度及特异度

发布时间：2018-08-18 11:10

【摘要】：目的探讨血栓弹力图(TEG)预测老年重症患者血栓发生的敏感度与特异度的临床应用价值。方法选取该院重症监护室(ICU)于2015年10月至2016年12月收治的200例重症患者进行回顾性分析,均接受TEG、常规凝血功能指标检测及血小板计数(PLT)检查,对TEG参数、凝血4项指标、PLT所得结果进行相关性分析,并对TEG、常规凝血功能指标预测敏感度、特异度进行评价。结果 TEG参数凝血反应时间(R)与凝血酶原时间(PT)无相关性,与活化部分凝血活酶时间(APTT)呈正相关,TEG参数凝血形成时间(K)与纤维蛋白原(Fib)、PLT呈负相关,TEG参数最大凝块强度(MA)与Fib、PLT呈正相关,TEG参数凝固角(Angle)与Fib、PLT呈正相关(均P0.05);TEG参数R、K、MA、Angle与D-二聚体(D-dimer)均无相关性(P0.05);TEG参数R与K呈正相关,MA、Angle与K均呈负相关,MA与R呈负相关,MA与Angle呈正相关,Angle与R呈负相关(均P0.05);TEG、常规凝血功能指标预测血栓敏感度均50.0%,但TEG参数预测特异度高于常规凝血功能指标。结论 TEG预测老年重症患者血栓发生的敏感度较低,特异度较高,能降低血栓发生误诊风险,具有一定指导意义,且与常规凝血功能指标无法相互替代,实际应用需与临床、实验室检测结合进行综合考虑。
[Abstract]:Objective To investigate the clinical value of thromboelastography (TEG) in predicting the sensitivity and specificity of thrombosis in elderly critically ill patients.Methods 200 critically ill patients admitted to intensive care unit (ICU) from October 2015 to December 2016 were retrospectively analyzed. Results There was no correlation between TEG parameters, prothrombin time (PT), activated partial thromboplastin time (APTT), TEG parameters and coagulation formation time (PT). The maximum coagulation strength (MA) of TEG parameters was positively correlated with Fib and PLT, and the coagulation angle (Angle) of TEG parameters was positively correlated with Fib and PLT (all P 0.05); the TEG parameters R, K, MA, Angle and D-dimer (D-dimer) were not negatively correlated (P 0.05); the TEG parameters R and K were positively correlated, MA, Angle and K were negatively correlated, MA and MA and R were negatively correlated. MA was positively correlated with Angle, Angle was negatively correlated with R (all P It is of guiding significance and can not be substituted with conventional coagulation function indexes. The practical application should be considered comprehensively in combination with clinical and laboratory tests.
【作者单位】：云南省第二人民医院输血科;
【分类号】：R459.7

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