血栓弹力图对热射病合并弥散性血管内凝血的诊断及预后判断价值
R135.3; 目的 探讨血栓弹力图(TEG)对热射病(HS)合并弥散性血管内凝血(DIC)的诊断及预后判断价值.方法 选取解放军94医院重症医学科2016年6月-2017年9月收治的HS患者32例.收集患者入科2h内静脉血,检测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)、凝血酶原时间(TT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)、抗凝血酶Ⅲ(ATⅢ)和TEG指标.比较ISTH-DIC(国际血栓与止血学会诊断标准)与TEG-DIC诊断标准.患者根据预后分为生存组(n=24)与死亡组(n=8),比较两组患者入科时常规凝血指标与TEG各指标的变化,...
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| Published in | 解放军医学杂志 Vol. 43; no. 9; pp. 752 - 755 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
330002,南昌 解放军94医院重症医学科
2018
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| Subjects | |
| Online Access | Get full text |
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| Abstract | R135.3; 目的 探讨血栓弹力图(TEG)对热射病(HS)合并弥散性血管内凝血(DIC)的诊断及预后判断价值.方法 选取解放军94医院重症医学科2016年6月-2017年9月收治的HS患者32例.收集患者入科2h内静脉血,检测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)、凝血酶原时间(TT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)、抗凝血酶Ⅲ(ATⅢ)和TEG指标.比较ISTH-DIC(国际血栓与止血学会诊断标准)与TEG-DIC诊断标准.患者根据预后分为生存组(n=24)与死亡组(n=8),比较两组患者入科时常规凝血指标与TEG各指标的变化,分析TEG评分与病死率的相关性.结果 与生存组凝血反应时间[R值,6.5(5.70～11.6)min]及血块形成速率[K值,3.8(2.30～6.3)min]相比,死亡组R值[30.9(10.28～88.58)min]与K值[22.4(4.9～41.63)min]明显延长.与生存组血块形成动力学指标α角(45.77±19.06)°、血块最大强度MA值(46.82±13.45mm)、凝血综合指数[CI值,–3.1(–10.30～–1.50)]相比,死亡组α角(12.68±13.65)°、MA值(19.60±21.67mm)及CI值[–22.3(–45.18～–17.3)]均明显降低,差异有统计学意义(P<0.05).符合TEG-DIC诊断标准的DIC患者发病率较ISTH-DIC高,TEG评分与病死率呈正相关(r2=0.8372,P=0.0292).结论 TEG评分≥2分可诊断HS合并DIC以及判断预后不良. |
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| AbstractList | R135.3; 目的 探讨血栓弹力图(TEG)对热射病(HS)合并弥散性血管内凝血(DIC)的诊断及预后判断价值.方法 选取解放军94医院重症医学科2016年6月-2017年9月收治的HS患者32例.收集患者入科2h内静脉血,检测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)、凝血酶原时间(TT)、纤维蛋白降解产物(FDP)、D-二聚体(D-D)、抗凝血酶Ⅲ(ATⅢ)和TEG指标.比较ISTH-DIC(国际血栓与止血学会诊断标准)与TEG-DIC诊断标准.患者根据预后分为生存组(n=24)与死亡组(n=8),比较两组患者入科时常规凝血指标与TEG各指标的变化,分析TEG评分与病死率的相关性.结果 与生存组凝血反应时间[R值,6.5(5.70～11.6)min]及血块形成速率[K值,3.8(2.30～6.3)min]相比,死亡组R值[30.9(10.28～88.58)min]与K值[22.4(4.9～41.63)min]明显延长.与生存组血块形成动力学指标α角(45.77±19.06)°、血块最大强度MA值(46.82±13.45mm)、凝血综合指数[CI值,–3.1(–10.30～–1.50)]相比,死亡组α角(12.68±13.65)°、MA值(19.60±21.67mm)及CI值[–22.3(–45.18～–17.3)]均明显降低,差异有统计学意义(P<0.05).符合TEG-DIC诊断标准的DIC患者发病率较ISTH-DIC高,TEG评分与病死率呈正相关(r2=0.8372,P=0.0292).结论 TEG评分≥2分可诊断HS合并DIC以及判断预后不良. |
| Author | 钟林翠 林青伟 宋晓敏 曾庆波 宋景春 吴阳 邓星平 |
| AuthorAffiliation | 330002,南昌 解放军94医院重症医学科 |
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| Author_FL | ZHONG Lin-cui ZENG Qing-bo WU Yang SONG Jing-chun LIN Qing-wei DENG Xing-ping SONG Xiao-min |
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| Author_xml | – sequence: 1 fullname: 曾庆波 – sequence: 2 fullname: 宋景春 – sequence: 3 fullname: 林青伟 – sequence: 4 fullname: 宋晓敏 – sequence: 5 fullname: 邓星平 – sequence: 6 fullname: 吴阳 – sequence: 7 fullname: 钟林翠 |
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| Keywords | 血栓弹力图 弥散性血管内凝血 热射病 |
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| Title | 血栓弹力图对热射病合并弥散性血管内凝血的诊断及预后判断价值 |
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