| 王希龙,刘建军,寇立臣,赵玲芳,刘 东.血栓弹力图联合凝血指标评估脓毒症病情严重程度的临床价值分析[J].,2018,(17):3340-3343 |
| 血栓弹力图联合凝血指标评估脓毒症病情严重程度的临床价值分析 |
| Analysis of the Clinical value of TEG Combined with Coagulation Tests For Eualuating the Severity of Sepsis |
| 投稿时间：2017-12-29 修订日期：2018-01-25 |
| DOI：10.13241/j.cnki.pmb.2018.17.030 |
| 中文关键词: 脓毒症 脓毒症休克 血栓弹力图 凝血指标 |
| 英文关键词: Sepsis Septic Shock Thrombelastograph Coagulation tests |
| 基金项目:全军医药科研"十二五"面上项目(CLZ12JA04)；甘肃省自然科学基金项目(1308RJYA06) |
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| 中文摘要: |
| 摘要 目的：探讨血栓弹力图(TEG)联合常规凝血指标评估脓毒症病情严重程度的临床价值。方法：选取2015年11月-2016年11月兰州军区兰州总医院重症医学科收治的重症感染患者97例为研究对象。依据脓毒症3.0将患者分为脓毒症(Sepsis)组(67例)、脓毒症休克(Septic Shock)组(30例)。完善相关检查后，检测和比较两组常规凝血功能指标(活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、D-二聚体(D-D))，描绘TEG(血凝时间(R)、血块成型时间(K)、α角、血块强度(MA))的差异及以上指标之间的相关性。结果：脓毒症休克组PT、APTT、FIB和D-D水平均较脓毒症组显著升高(P<0.05)，R、K均较脓毒症组显著缩短(P<0.05)，而α角、MA均较脓毒症组显著增大(P<0.05)。TEG中R值、K值与PT、APTT呈正相关(r=0.439、0.267、0.379、0.136)，与FIB、D-D呈负相关(r=-0.397、-0.671、-0.628、-0.534)；α角、MA值与PT、APTT呈负相关(r=-0.127、-0.238、-0.459、-0.213)，与FIB、D-D呈正相关(r=0.386、0.53、0.687、0.652)。结论：TEG联合凝血指标可较真实地判断脓毒症患者凝血纤溶状态，为脓毒症患者病情严重程度的判断提供更可靠的依据。 |
| 英文摘要: |
| ABSTRACT Objective: To Analysis of clinical value of thrombelastograph (TEG) combined coagulation tests eualuating severity of illness in the sepsis patients. Methods: From November 2015 to November 2016, 97 cases of sepsis patient were studied. The patients were divided into two groups according to sepsis3.0 : sepsis group (n=67), septic shock group (n=30). Coagulation tests(activated partial thromboplastin time(APTT), prothrombin(PT), fibrinogen(FIB) and D-Dimmer(D-D) )in the two groups were checked and compared. The differience of theTEG((reaction time (R), kinetics of clot development (K), α angle and maximum amplitude ( MA))were described in the two groups simultaneously and the relativity of monitoring index were analyzed. Results: The value of PT, APTT, FIB and D-D in septic shock group were larger than those in sepsis group, and there was significant differences (P<0.05). Compared with sepsis group, the value of R and K in septic shock group significantly decreased(P<0.05), and the value of a angle and MA obviously increased (P<0.05). The value R and K had the positive correlation with PT and APTT (r=0.439, 0.267, 0.379, 0.136), and had negative correlation with FIB and D-D (r=-0.397, -0.671, -0.628, -0.534). The value of a angle and MA negatively correlated with PT and APTT(r=-0.127, -0.238, -0.459, -0.213), and positively correlated with FIB and DD (r=0.386, 0.553, 0.687, 0.652). Conclusion: TEG combined conventional co- agulation test could comparatively accurately evaluate the coagulation and fibrinolysis state of patients with sepsis, and assess the severity of illness in the sepsis patient.It's helpful to clinical care for sepsis. |
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