血栓弹力图评价急性创伤患者早期血小板功能的改变

发布时间：2018-05-13 03:20

本文选题：创伤 + 血栓弹力图　；参考：《临床检验杂志》2016年10期

【摘要】：目的用血栓弹力图(TEG)血小板图分析急性创伤后血小板抑制功能的改变。方法用TEG检测51例急诊创伤患者及48例健康人全血血小板二磷酸腺苷(ADP)抑制率及花生四烯酸(AA)抑制率,并用logistic回归分析创伤患者的高危风险因素。结果创伤患者平均二磷酸腺苷(ADP)抑制率(%)为85.9(38.4,97.6)、平均花生四烯酸(AA)抑制率(%)为44.7(26.4,59.1),健康人平均ADP抑制率(%)为4.4(0,18.1)、平均AA抑制率(%)为0.7(0,3.03),创伤组与健康人对照组血小板抑制率差异有统计学意义(P0.01)。以ADP抑制率是否大于75%为cut off值,患者碱缺失(BD)6 m Eq/L(OR=3.21,95%CI:1.45~9.31)和6 h内至少输注血浆200 m L(OR=4.9,95%CI:0.89~28.8)为患者的高危风险因素;以ADP抑制率是否大于90%为cut off值,患者收缩压70 mm Hg(OR=12.4,95%CI:1.8~91.4)和患者6 h内至少输注红细胞悬液2 U(OR=8.7,95%CI:1.8~46.5)为患者的高危风险因素。结论创伤患者血小板AA及ADP抑制率明显升高,血小板活化功能降低;血制品输注增加创伤患者风险。
[Abstract]:Objective to analyze the changes of platelet suppressor function after acute trauma by thromboelastography (TEG). Methods the inhibition rate of platelet adenosine diphosphate (ADP) and arachidonic acid (AA) were measured by TEG in 51 emergency trauma patients and 48 healthy controls. The high risk factors of trauma patients were analyzed by logistic regression analysis. Results the average inhibition rate of adenosine diphosphate (ADP) in trauma patients was 85.9 / 38.497 / 6 and the inhibition rate of arachidonic acid was 44.726.4 / 59.1a, respectively. The average inhibition rate of ADP in healthy persons was 4.4n018.1and the average inhibition rate of AA was 0.700.03). The difference of rate was statistically significant (P 0.01). Taking whether the inhibition rate of ADP was greater than 75% as cut off value, the risk factors of patients with 6 m EQ / L OR3. 21% CI: 1. 45% CI: 9.31) and at least 6 h infusion of plasma 200 m L / L or at least 4. 9% CI: 0. 89% 28. 8) were the high risk factors for the patients, and whether the inhibition rate of ADP was greater than 90% was the value of cut off. The high risk factors were the systolic blood pressure of 70 mm Hgorus 12.4 + 95% CI: 1. 8% 91.4) and the RBC suspension of at least 8. 7% CI: 1. 8 + 45. 5) within 6 hours. Conclusion the inhibition rate of platelet AA and ADP was significantly increased and the platelet activation function was decreased in trauma patients, and transfusion of blood products increased the risk of trauma patients.
【作者单位】：宁夏人民医院临床医学检验诊断中心;
【基金】：宁夏自然科学基金(NZ15192)
【分类号】：R641;R446.11

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