摘要
目的探究血栓弹力图(TEG)和凝血四项各参数在髋部骨折术后患者凝血功能中的相关性。方法选择2019年7月至2022年6月于我院接受人工髋关节置换术的60例患者作为研究对象,对患者围术期开展观察,记录其TEG、凝血四项、血小板(PLT)的检测结果,将TEG的主要参数凝血因子激活时间(R)、血块形成速率参数(K)、弹力图最大切角(Angle角)、弹力图最大振幅(MA)与凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及PLT进行相关性分析,并通过绘制ROC曲线,分析TEG对人工髋关节置换术后患者凝血功能的诊断价值。结果TEG中的R值与PT值无相关性(r=0.014,P=0.488),与APTT同样无相关性(r=-0.014,P=0.467)。K值与FIB呈明显负相关性(r=-0.288,P<0.001),Angle与FIB呈明显正相关性(r=0.273,P<0.001),MA值与FIB值呈现明显正相关性(r=0.415,P<0.001)。K值与PLT呈现明显的负相关性(r=-0.164,P=0.010),Angle与PLT呈现明显的正相关(r=0.190,P=0.005),MA值与PLT呈现明显的正相关(r=0.237,P=0.002)。R、K、Angle及MA值对高凝的鉴别曲线下面积(AUC)为0.556(P=0.624)、0.923(P<0.001)、0.885(P<0.001)、0.923(P<0.001)。R、K、Angle及MA值对低凝的鉴别AUC为0.6308(P=0.361)、0.8308(P=0.021)、0.808(P=0.032)、0.7654(P=0.064)。结论人工髋关节置换术患者围手术期TEG和凝血四项指标存在一定的相关性,TEG中K、Angle及MA值对于患者的凝血状态具有较高诊断价值,可以考虑将TEG和凝血四项应用于人工髋关节置换术患者围手术期凝血状态评估中,从而为患者的血栓检测和风险评估提供参考依据。
Objective To investigate the correlation between TEG and four parameters of coagulation in patients with hip fracture.Method 60 patients who received artificial hip replacement in our hospital from July 2019 to June 2022 were selected as the research objects.Perioperative observation was carried out on the patients,and the test results of TEG,coagulation and platelet(PLT)were recorded.The main parameters of TEG,coagulation factor activation time(R),clot formation rate parameter(K),elastic graph maximum Angle(Angle),elastic graph maximum amplitude(MA),prothrombin time(PT),activated partial thrombin time(APTT),and fibrinogen(FIB),were analyzed.The diagnostic value of TEG for coagulation function after hip arthroplasty was analyzed by drawing ROC curve.Result There is no correlation between R value in TEG and PT value(r=0.014,P=0.488),and there is no correlation between R value in TEG and APTT(r=-0.014,P=0.467).There is a significant negative correlation between K and FIB(r=-0.288,P<0.001),a significant positive correlation between Angle and FIB(r=0.273,P<0.001),and a significant positive correlation between MA and FIB(r=0.415,P<0.001).There is a significant negative correlation between K and PLT(r=-0.164,P=0.010),a significant positive correlation between Angle and PLT(r=0.190,P=0.005),and a significant positive correlation between MA and PLT(r=0.237,P=0.002).The differential AUC of R,K,Angle and MA values for hypercoagulability is 0.556(P=0.624),0.923(P<0.001),0.885(P<0.001)and 0.923(P<0.001).The differential AUC of R,K,Angle and MA values for low coagulation is 0.631(P=0.361),0.831(P=0.021),0.808(P=0.032)and 0.765(P=0.064).Conclusion There is a certain correlation between perioperative TEG and the four indexes of coagulation in patients undergoing artificial hip replacement.The values of K,Angle and MA in TEG have high diagnostic value for patients’coagulation status.Therefore,TEG and the four indexes of coagulation can be considered to be applied in the perioperative coagulation status evaluation of patients undergoing artificial hip replacement to provide reference for thrombosis detection and risk assessment of patients.
作者
陈敏
曾志
刘建
项惠灿
Min CHEN;Zhi ZENG;Jian LIU;Hui-Can XIANG(Department of Orthopedics,Longyan People's Hospital,Longyan 364000,Fujian Province,China;Department of Blood Transfusion,Longyan People's Hospital,Longyan 364000,Fujian Province,China;Department of Radiation Medicine,Longyan People's Hospital,Longyan 364000,Fujian Province,China)
出处
《数理医药学杂志》
CAS
2023年第1期16-23,共8页
Journal of Mathematical Medicine
基金
龙岩市科技创新联合资金卫生项目(2020LYF17022)。
关键词
髋部骨折内固定
人工关节置换术
血栓弹力图
凝血四项
Internal fixation of hip fracture
Artificial joint replacement
Thromboelastogram
Coagulation four
