Objective:To investigate the application value of thrombelastogram(TEG)in the detection of platelet inhibition rate for antiplatelet therapy for acute non-cardiogenic stroke.Methods:A total of 100 patients with ischem...Objective:To investigate the application value of thrombelastogram(TEG)in the detection of platelet inhibition rate for antiplatelet therapy for acute non-cardiogenic stroke.Methods:A total of 100 patients with ischemic non-cardiogenic stroke were selected for this study from September 2020 to October 2021.Patients were randomly divided into experimental group and control group,with 50 cases for each group.Before and after 1 week of antiplatelet drug treatment,the platelet inhibition rate in the experimental group was measured with arachidonic acid(AA)and adenosine diphosphate(ADP)by TEG;no platelet inhibition rates detection was conducted for the control group.The dose and type of drugs were adjusted for the experimental group according to the platelet functions and medication based on the clinical experience conducted for the control group.The neurological deficits of the discharged patients were scored with NIHSS score,mRS score,stroke recurrence,hemorrhage,and other events were followed up at the 3rd month of discharge.Results:In the experimental group,the inhibition rates of AA and ADP were significantly higher than those before treatment(both P<0.05).After treatment,the inhibition rates of AA and ADP in dual antiplatelet patients were higher than those of monoclonal antiplatelets(both P<0.05).The NIHSS score at discharge and the mRS score at the 3rd-month-follow-up in the experimental group were lower than those in the control group(both P<0.05).The incidences of stroke recurrence and hemorrhage events in the experimental group were lower than those in the control group(P<0.05).Conclusion:The application of a thrombelastogram in the detection of platelet inhibition rate to guide antiplatelet therapy in patients with acute non-cardiogenic stroke reduces the recurrences of cerebral infarction and the risk of hemorrhage and improves patients’clinical prognosis.展开更多
目的分析慢性肾衰竭(CRF)血液透析中不同血管透析通路对透析效果的影响。方法选取2018年10月至2022年9月于该院接受血液透析的206例CRF患者为研究对象,按照随机数字表法分为A组和B组,各103例。A组采用自体动静脉内瘘(AVF),B组采用带隧...目的分析慢性肾衰竭(CRF)血液透析中不同血管透析通路对透析效果的影响。方法选取2018年10月至2022年9月于该院接受血液透析的206例CRF患者为研究对象,按照随机数字表法分为A组和B组,各103例。A组采用自体动静脉内瘘(AVF),B组采用带隧道带涤纶套透析导管(TCC)。比较2组透析效果、免疫-炎症指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、诱导性T淋巴细胞(CD4^(+))比例、CD4^(+)/抑制性T淋巴细胞(CD8^(+))比值]、肾功能指标[尿素氮(BUN)、24 h尿蛋白定量(24 h Upro)、血肌酐(Scr)]、血栓弹力图(TEG)参数(α角、K值)、并发症、主要心血管不良事件(MACE)。结果透析6个月后,A组尿素清除指数(Kt/V)、尿素下降率(URR)明显高于B组,差异均有统计学意义(P<0.05)。重复测量方差分析结果显示:两组血清IL-6、CRP、CD4^(+)比例、CD4^(+)/CD8^(+)比值、BUN、24 h Upro、Scr、α角、K值存在交互效应、时间效应、组间效应,差异均有统计学意义(P<0.05)。多变量方差分析结果显示:A组透析1、3、6个月后血清IL-6、CRP水平低于B组,CD4^(+)比例、CD4^(+)/CD8^(+)比值高于B组,差异均有统计学意义(P<0.05)。A组透析1个月、3个月、6个月后BUN、24 h Upro、Scr高于B组,差异均有统计学意义(P<0.05)。A组透析1、3、6个月后α角低于B组,K值高于B组,差异均有统计学意义(P<0.05);A组并发症、MACE发生率分别为5.83%、4.85%,低于B组的15.53%、13.59%,差异均有统计学意义(P<0.05)。结论与TCC通路相比,AVF通路可提升CRF患者血液透析效果,改善患者肾功能,减轻机体炎症反应,调节TEG参数,降低并发症、MACE发生风险。展开更多
文摘Objective:To investigate the application value of thrombelastogram(TEG)in the detection of platelet inhibition rate for antiplatelet therapy for acute non-cardiogenic stroke.Methods:A total of 100 patients with ischemic non-cardiogenic stroke were selected for this study from September 2020 to October 2021.Patients were randomly divided into experimental group and control group,with 50 cases for each group.Before and after 1 week of antiplatelet drug treatment,the platelet inhibition rate in the experimental group was measured with arachidonic acid(AA)and adenosine diphosphate(ADP)by TEG;no platelet inhibition rates detection was conducted for the control group.The dose and type of drugs were adjusted for the experimental group according to the platelet functions and medication based on the clinical experience conducted for the control group.The neurological deficits of the discharged patients were scored with NIHSS score,mRS score,stroke recurrence,hemorrhage,and other events were followed up at the 3rd month of discharge.Results:In the experimental group,the inhibition rates of AA and ADP were significantly higher than those before treatment(both P<0.05).After treatment,the inhibition rates of AA and ADP in dual antiplatelet patients were higher than those of monoclonal antiplatelets(both P<0.05).The NIHSS score at discharge and the mRS score at the 3rd-month-follow-up in the experimental group were lower than those in the control group(both P<0.05).The incidences of stroke recurrence and hemorrhage events in the experimental group were lower than those in the control group(P<0.05).Conclusion:The application of a thrombelastogram in the detection of platelet inhibition rate to guide antiplatelet therapy in patients with acute non-cardiogenic stroke reduces the recurrences of cerebral infarction and the risk of hemorrhage and improves patients’clinical prognosis.
文摘目的分析慢性肾衰竭(CRF)血液透析中不同血管透析通路对透析效果的影响。方法选取2018年10月至2022年9月于该院接受血液透析的206例CRF患者为研究对象,按照随机数字表法分为A组和B组,各103例。A组采用自体动静脉内瘘(AVF),B组采用带隧道带涤纶套透析导管(TCC)。比较2组透析效果、免疫-炎症指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)、诱导性T淋巴细胞(CD4^(+))比例、CD4^(+)/抑制性T淋巴细胞(CD8^(+))比值]、肾功能指标[尿素氮(BUN)、24 h尿蛋白定量(24 h Upro)、血肌酐(Scr)]、血栓弹力图(TEG)参数(α角、K值)、并发症、主要心血管不良事件(MACE)。结果透析6个月后,A组尿素清除指数(Kt/V)、尿素下降率(URR)明显高于B组,差异均有统计学意义(P<0.05)。重复测量方差分析结果显示:两组血清IL-6、CRP、CD4^(+)比例、CD4^(+)/CD8^(+)比值、BUN、24 h Upro、Scr、α角、K值存在交互效应、时间效应、组间效应,差异均有统计学意义(P<0.05)。多变量方差分析结果显示:A组透析1、3、6个月后血清IL-6、CRP水平低于B组,CD4^(+)比例、CD4^(+)/CD8^(+)比值高于B组,差异均有统计学意义(P<0.05)。A组透析1个月、3个月、6个月后BUN、24 h Upro、Scr高于B组,差异均有统计学意义(P<0.05)。A组透析1、3、6个月后α角低于B组,K值高于B组,差异均有统计学意义(P<0.05);A组并发症、MACE发生率分别为5.83%、4.85%,低于B组的15.53%、13.59%,差异均有统计学意义(P<0.05)。结论与TCC通路相比,AVF通路可提升CRF患者血液透析效果,改善患者肾功能,减轻机体炎症反应,调节TEG参数,降低并发症、MACE发生风险。
