摘要
目的:探讨联合检测血栓弹力图(thrombelastogram,TEG)与抗Xa因子在深静脉血栓(deep venous thrombosis,DVT)低分子肝素治疗中的临床应用价值。方法:选取2017年1月-2018年12月于本院住院并采用低分子肝素治疗的深静脉血栓患者60例,分别于溶栓前和溶栓后1、2、3、6 h采集其静脉血进行TEG、PT、APTT及抗Xa因子活性检测。比较不同时间点TEG参数中凝血反应时间(R值)、全血凝固时间(K值)、凝固角(α角)、血栓最大振幅(MA值)以及PT、APTT、抗Xa因子活性的差异;分析TEG各参数与PT、APTT及抗Xa因子相关性。结果:与溶栓前比较,R值在溶栓1、2、3、6 h后均升高,K值在溶栓1、2、3 h后均升高,MA值在溶栓1、2、3、6 h后均降低,α角在溶栓1、2、3 h后均降低,差异均有统计学意义(P<0.05)。与溶栓前比较,PT、APTT、抗Xa因子活性在溶栓1、2、3、6 h后均升高,差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,R值、K值分别与PT、APTT、抗Xa因子成直线正相关关系,α角、MA值分别与PT、APTT、抗Xa因子成直线负相关关系,差异均有统计学意义(P<0.05)。结论:TEG与抗Xa因子具有一定的相关性,联合检测更有助于DVT患者低分子肝素溶栓治疗凝血功能的动态评估以及临床治疗。
Objective:To explore the clinical application value of combined detection of thromboelastography(TEG)and anti-Xa factor in the treatment of deep vein thrombosis(DVT)with low molecular weight heparin.Method:A total of 60 patients with deep vein thrombosis who were admitted to our hospital from January 2017 to December 2018 and treated with low molecular weight heparin were selected.The venous blood was collected for TEG,PT,APTT and anti-Xa activity detection before thrombolysis and 1,2,3 and 6 h after thrombolysis.The coagulation reaction time(R value),coagulation time of whole blood(K value),coagulation Angle(Angle),maximum amplitude of thrombus(MA value),PT,APTT,and anti-Xa factor activity among TEG parameters at different time points were compared;the correlation of TEG parameters with PT,APTT and anti-Xa factor was analyzed.Result:Compared with those before thrombolysis,R value increased at 1,2,3,and 6 h,K value increased at 1,2,and 3 h,MA value decreased at 1,2,3,and 6 h,Angle decreased at 1,2,and 3 h,with statistically significant differences(P<0.05).Compared with those before thrombolysis,the activity of PT,APTT and anti-Xa factors all increased after thrombolysis for 1,2,3 and 6 h,with statistically significant differences(P<0.05).Pearson correlation analysis showed that R value and K value were positively correlated with PT,APTT and anti-Xa,respectively,Angle and MA were negatively correlated with PT,APTT and anti-Xa,respectively,with statistically significant differences(P<0.05).Conclusion:TEG has a certain correlation with anti-Xa factor,and joint detection is more helpful for the dynamic evaluation and clinical treatment of coagulation function of low molecular weight heparin thrombolytic therapy in patients with DVT.
作者
徐静
XU Jing(Ganzhou People’s Hospital of Jiangxi Province,Ganzhou 341000,China)
出处
《中国医学创新》
CAS
2020年第34期77-80,共4页
Medical Innovation of China
基金
赣州市指导性科技计划项目(GZ2019ZSF122)。
关键词
血栓弹力图
抗XA因子
低分子肝素
深静脉血栓
Thromboelastography
Anti-Xa factor
Low molecular heparin
Deep vein thrombosis
