摘要
目的:分析血小板聚集功能联合血栓弹力图在脑梗死溶栓术后检测中的应用价值。方法:选取2021年1月至2024年6月在我院接受溶栓术治疗的脑梗死患者84例,根据患者预后情况分为预后良好组与预后不良组,比较两组患者术后早期血小板聚集功能[花生四烯酸诱导的血小板聚集率(Arachidonic acid induced maximum platelet aggregation rate,AA-MAR)、二磷酸腺苷诱导的血小板聚集率(Adenosine diphosphate induced maximum platelet aggregation rate,ADP-MAR)],血栓弹力图[凝血反应时间(Coagulation reaction time,R)、血凝块形成时间(Coagulation time,K)、血凝块形成速率(Formation rate of blood clot,Angle)、最大血栓振幅(Maximum thrombus amplitude,MA)、凝血指数(Coagulation index,CI)],并采用多因素Logistic回归分析上述指标与脑梗死患者溶栓术后预后的关系,同时采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析血小板聚集功能联合血栓弹力图参数对脑梗死溶栓术治疗预后不良的预测价值。结果:与预后良好组相比,预后不良组AA-MAR、ADP-MAR、Angle、MA、CI显著高,R、K显著低(P<0.05),经Logistic回归分析表明AA-MAR、ADP-MAR、R、K是脑梗死溶栓术后预后的独立影响因素(P<0.05)。血小板聚集功能联合血栓弹力图参数联合预测脑梗死溶栓术治疗预后不良的ROC曲线下面积为0.961。结论:脑梗死患者溶栓术后早期血小板聚集功能、血栓弹力图均可影响预后,其定量参数联合检测预测预后有较高价值。
Objective:To analyze the application value of platelet aggregation combined with thromboelastography in detection after thrombolysis for cerebral infarction.Methods:Eighty-four patients with cerebral infarction who underwent thrombolysis in the hospital from January 2021 to June 2024 were selected,and divided into the good prognosis group and the poor prognosis group according to the prognosis.The indexes of postoperative early platelet aggregation[arachidonic acid induced maximum platelet aggregation rate(AA-MAR)and adenosine diphosphate induced maximum platelet aggregation rate(ADP-MAR)]and thromboelastography parameters[coagulation reaction time(R),coagulation time(K),formation rate of blood clot(Angle),maximum thrombus amplitude(MA)and coagulation index(CI)]were compared between the two groups.The relationship between above parameters and the prognosis of cerebral infarction after thrombolysis was analyzed.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of platelet aggregation combined with thromboelastography parameters for poor prognosis of cerebral infarction after thrombolysis.Results:Compared with the good prognosis group,AA-MAR,ADP-MAR,Angle,MA and CI were significantly higher,and R and K were significantly lower in the poor prognosis group(P<0.05).Logistic regression analysis showed that AA-MAR,ADP-MAR,R,and K were independent factors influencing the prognosis of cerebral infarction after thrombolysis(P<0.05).The area under the ROC curve of platelet aggregation combined with thromboelastography parameters for predicting poor prognosis of cerebral infarction after thrombolysis was 0.961.Conclusion:Early platelet aggregation and thromboelastography after thrombolysis affect the prognosis in patients with cerebral infarction.Combined detection of quantitative parameters has high prognostic value.
作者
张翠
尹琼
熊艳兵
席海龙
Zhang Cui;Yin Qiong;Xiong Yan-bing;Xi Hai-long(Department of Laboratory Medicine,Xinyu People's Hospital,Xinyu 338000,Jiangxi,China;Department of Otolaryngology,Fenyi County People's Hospital,Xinyu 338000,Jiangxi,China;Department of Cardiovascular Medicine,Xinyu People's Hospital,Xinyu 338000,Jiangxi,China)
关键词
血小板聚集功能
血栓弹力图
脑梗死
溶栓术
Platelet aggregation
Thromboelastography
Cerebral infarction
Thrombolysis
