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目的:探讨动脉瘤性蛛网膜下腔出血(aSAH)急性期(1周内)凝血因子的变化规律及其与深静脉血栓形成(DVT)的关系。方法:选择郑州大学第一附属医院神经重症科自2015年3月至2019年3月收治的202例aSAH患者(aSAH组)，发病后第1、3天根据患者是否合并DVT，将其分为合并DVT组和未合并DVT组。另外选择100例年龄和性别与aSAH组患者相匹配的健康体检者作为对照组，于aSAH患者发病后第1、3、5、7天，对照组入组第1天采用血栓弹力图(TEG)检测受试者TEG的R值(TEG-R)。aSAH患者发病后第1、2、3、4、5、6、7天采用四肢彩色多普勒超声检查确定有无DVT。结果:aSAH急性期共73例(36.14%)患者合并DVT。其中无症状性血栓患者66例，症状性血栓患者7例；下肢肌间静脉血栓59例，肌间合并其他深静脉血栓14例。发病后第1~3天合并DVT 68例(93.20%)，是DVT的高峰期。发病后第1、3天，aSAH组患者的TEG-R低于对照组，差异有统计学意义(n P<0.05)；发病后第1、3天aSAH组患者的TEG-R低于发病后第5、7天，差异有统计学意义(n P<0.05)。发病后第1、3天，合并DVT组患者的TEG-R均低于未合并DVT组，差异均有统计学意义(n P<0.05)。n 结论:aSAH发病后第1~3天内凝血因子功能增强，DVT发生率最高，以无症状性的肌间静脉血栓为主；是否合并DVT与凝血因子功能亢进有关。“,”Objective:To explore the changes of levels of coagulation factors at acute phase (within one week) of aneurysmal subarachnoid hemorrhage (aSAH) and their relations with deep venous thrombosis (DVT).Methods:Two hundred and two aSAH patients (aSAH group), admitted to our hospitals from March 2015 to March 2019, were selected in our study, and these patients were divided into a combined DVT subgroup and a uncombined DVT subgroup according to whether they were combined with DVT on the first and third d of onset. One hundred healthy physical examiners whose age and gender matched with those of aSAH group were selected as control group; one, 3, 5, and 7 d after onset, and one d after enrolling of subjects from the control group, thromboelastogram (TEG) was used to detect the R value of TEG (TEG-R) in all subjects. One, two, 3, 4, 5, 6 and 7 d after onset, color Doppler ultrasonography was used to determine whether aSAH patients had DVT.Results:A total of 73 patients (36.14%) were combined with DVT at acute stage of aSAH; 66 were with asymptomatic thrombosis and 7 with symptomatic thrombosis; 59 were with lower extremity intermuscular vein thrombosis and 14 were with intermuscular vein thrombosis. The incidence of DVT (68/73 [93.2%]) peaked on the 1n st-3n rd d of onset. The TEG-R of patients in aSAH group was statistically lower than that of the control group on the 1n st-3n rd d of onset (n P<0.05); the TEG-R of patients in aSAH group on the 1n st-3n rd d of onset was significantly lower than that on 5n th and 7n th d of onset (n P<0.05). The TEG-R of patients in combined DVT subgroup was significantly lower than that of the uncombined DVT subgroup (n P<0.05).n Conclusions:Hyperfunction of coagulation factors at acute stage of aSAH is noted within one-3 d of onset; the incidence of DVT is the highest within 3 d of onset, mainly featured as asymptomatic intermuscular venous thrombosis. Whether or not aSAH would combine with DVT is associated with hyperfunction of coagulation factors.