血栓弹力图检测动脉瘤性蛛网膜下腔出血后血小板功能变化及与再出血的关系

发布时间：2018-05-11 23:00

本文选题：蛛网膜下腔出血 + 血栓弹力图　；参考：《第三军医大学学报》2017年03期

【摘要】：目的通过血栓弹力图(thromboelastography,TEG)检测探讨动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage,aSAH)后血小板功能的改变及其与再出血的关系。方法回顾性分析259例aSAH患者与39例未破裂动脉瘤(unruptured intracranial aneurysm,UIA)患者入院时TEG检测结果,比较两组间差异,探讨TEG参数与Hunt-Hess分级、Fisher分级的关系。根据有无再出血将aSAH患者分为再出血组与无再出血组,比较两组临床资料、血小板及其TEG参数的差异。结果aSAH组的二磷酸腺苷(adenosine diphosphate,ADP)抑制率显著高于UIA组(U=1 505,P0.01),ADP抑制率与Hunt-Hess分级(r=0.387,P0.01)、Fisher分级(r=0.382,P0.01)呈正相关。再出血患者花生四烯酸(arachidonic acid,AA)抑制率、ADP抑制率较无再出血患者明显增加(P0.05,P0.01)。结论 aSAH后存在血小板功能障碍,而再出血与血小板功能明显降低有关,TEG检测血小板功能可作为预警指标帮助评估aSAH的再出血风险。
[Abstract]:Objective to investigate the changes of platelet function after aneurysm subarachnoid hemorrhage (SAH) by thromboelastography (TEG) and its relationship with rebleeding. Methods the results of TEG examination on admission in 259 patients with aSAH and 39 patients with unruptured aneurysms were retrospectively analyzed. The difference between the two groups was compared, and the relationship between TEG parameters and Hunt-Hess grade was discussed. Patients with aSAH were divided into two groups according to whether there was rebleeding or not. The clinical data, platelet and TEG parameters were compared between the two groups. Results the inhibition rate of adenosine diphosphate in aSAH group was significantly higher than that in UIA group. The inhibition rate of adenosine diphosphate in aSAH group was significantly higher than that in UIA group. The inhibitory rate of arachidonic acid ADP in patients with recurrent hemorrhage was significantly higher than that in patients without rebleeding. Conclusion there are platelet dysfunction after aSAH, and the risk of aSAH rebleeding can be evaluated by the detection of platelet function by aSAH, which is related to the decrease of platelet function.
【作者单位】：重庆医科大学附属第二医院神经外科;重庆医科大学附属第一医院神经外科;
【分类号】：R743.35

【相似文献】