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目的通过对脑出血患者血栓弹力图(TEG)试验指标的检测,结合其发病机制分析其变化规律,分析脑出血患者应用TEG试验指标评估病情的可行性,为脑出血的诊治寻找客观的实验室指标。方法收集脑出血患者33例(脑出血组),按出血量分为小量亚组11例、中量亚组16例、大量亚组6例。另选择健康成人20例为对照组。受试对象完善TEG检查前均未进行药物或手术干预治疗。诊断以颅脑CT和MRI检查为主,CT评估脑出血量,应用北京中兴TEG YZ5000型弹力图仪检测TEG指标(R值、K值、angle、MA值、CI)。结果脑出血组K值高于对照组,Angle、MA低于对照组,差异均有统计学意义(P<0.05)。3亚组间CI比较差异无统计学意义(P>0.05);R值<10ml亚组、10~30ml亚组低于>30ml亚组(P<0.05),K值、Angle、MA 3亚组间两两比较均有差异(P<0.05)。脑出血组内K值、Angle、MA与脑出血量均有显著相关性(r=0.613、-0.481、-0.381,P值均<0.05);R值、CI与脑出血量无显著相关性(r=0.251、0.242,P>0.05)。结论 TEG能够动态且完整地反映凝血与纤溶的整个过程,K值、Angle与MA值可以作为监测脑出血患者凝血功能的一个新选择。
Objective To detect the change rule of thromboelastography (TEG) test in patients with intracerebral hemorrhage and analyze its changing mechanism according to its pathogenesis. To analyze the feasibility of applying TEG test index to evaluate the condition of cerebral hemorrhage and to find an objective laboratory for the diagnosis and treatment of cerebral hemorrhage index. Methods Thirty-three patients with intracerebral hemorrhage (ICH) were collected. According to the amount of bleeding, 11 cases were divided into small subgroup, 16 medium subgroup and 6 large subgroups. Another 20 healthy adults as the control group. Subjects without improvement of TEG examination before the drug or surgical intervention. The diagnosis was mainly based on CT and MRI. CT was used to evaluate the amount of cerebral hemorrhage. TEG index (R value, K value, angle, MA value, CI) was measured by Beijing Zhongxing TEG YZ5000 Elastogram Instrument. Results The K value of cerebral hemorrhage group was higher than that of control group, but Angle and MA were lower than that of control group (P <0.05). There were no significant differences in CI between 3 subgroups (P> 0.05); R value <10ml subgroup, 10 ~ 30ml subgroup was lower than> 30ml subgroup (P < There was difference between every two groups (P <0.05). The values of K, Angle and MA in cerebral hemorrhage group were significantly correlated with the volume of cerebral hemorrhage (r = 0.613, -0.481, -0.381, P <0.05). There was no significant correlation between R value, CI and the amount of cerebral hemorrhage r = 0.251,0.242, P> 0.05). Conclusion TEG can reflect the whole process of coagulation and fibrinolysis dynamically and completely. K value, Angle and MA value can be used as a new choice to monitor coagulation function in patients with intracerebral hemorrhage.