血栓弹力图对急性白血病患者出血风险的预测价值研究

发布时间：2018-06-10 14:02

本文选题：血栓弹力描记术 + 白血病　；参考：《重庆医学》2016年03期

【摘要】：目的探讨血栓弹力图(TEG)在急性白血病患者出血风险的评估及诊断价值中的作用。方法通过对127例急性白血病患者进行数据统计(共272组有效统计数据),将所有数据按临床有无出血分组(出血组、无出血组),比较两组TEG的4项指标[反应时间(R)、血凝块形成时间(K)、α角、最大振幅(MA)]和血小板(PLT)计数。对PLT30×10~9个/L者,按有无出血分组(有出血组、无出血组)并比较TEG的4项指标。通过ROC曲线,比较TEG不同指标与PLT计数评估出血风险的准确性与特异性。结果所有272组数据比较,出血组K值、R值大于无出血组,α角、MA值、PLT计数小于无出血组(P0.05);PLT30×10~9个/L的急性白血病患者,出血组K值大于无出血组,α角、MA小于无出血组(P0.05),两组R值、PLT计数差异无统计学意义(P0.05);PLT计数、MA值、α角诊断出血的ROC曲线下面积均大于0.5(分别为0.750、0.740、0.653)。结论 TEG能够预测急性白血病出血风险,有较好的临床实用性。
[Abstract]:Objective to evaluate the role of thromboelastography (TEG) in the evaluation and diagnosis of bleeding risk in patients with acute leukemia. Methods 127 patients with acute leukemia were divided into two groups according to the clinical data with or without bleeding. The counts of four indexes of TEG (reaction time, time of blood clot formation, 伪 -angle, maximum amplitude) and platelet count were compared between the two groups. The patients with PLT 30 脳 10 ~ 9 / L were divided into two groups (haemorrhage group, no bleeding group) and the four indexes of TEG were compared. The accuracy and specificity of different indexes of TEG and PLT count in assessing bleeding risk were compared by ROC curve. Results compared with all 272 groups, the K value and R value of bleeding group were higher than those of no bleeding group, and the 伪 -keratine MA value and PLT count were lower than that of P0.05 + PLT 30 脳 10 ~ 9 / L acute leukemia patients. K value of bleeding group was higher than that of no bleeding group, and 伪 -carrageenan MA was lower than that of non-bleeding group (P 0.05). There was no significant difference in PLT count between the two groups. The area under ROC curve of 伪 angle diagnosis of hemorrhage was more than 0.5 (0.750 卤0.740) and 0.653 (P < 0.05). Conclusion TEG can predict the risk of acute leukemia hemorrhage and has good clinical practicability.
【作者单位】：重庆医科大学附属第二医院血液内科;
【分类号】：R733.71

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