Comparison on thromboelastography and conventional coagulation tests for evaluating blood coagulation function in elderly patients with asymptomatic cerebral infarction

doi:10.3969/j.issn.1673-8640.2017.08.001

Abstract

Abstract:

Objective To investigate the commonness and difference between thromboelastography （TEG） and conventional coagulation tests for evaluating blood coagulation function in elderly patients with asymptomatic cerebral infarction （ACI）. Methods A total of 86 elderly patients with acute ACI （ACI group） and 90 healthy subjects （healthy control group） were enrolled. The 2 groups were determined by TEG and conventional coagulation tests simultaneously. After treatment for 4 weeks,TEG and conventional coagulation tests were performed as well in the 2 groups. Results The correlation analysis showed that reaction time （R）had positive correlations with prothrombin time（PT） and prothrombin time-international normalized ratio （PT-INR）,and had a negative correlation with fibrinogen （Fib）. Maximum clot strength（MA） was positively correlated with Fib,synthesize coagulation index（CI） was negatively correlated with PT and PT-INR,and CI was positively correlated with Fib. In ACI group,R,clotting time（K）,PT,PT-INR and activated partial thromboplastin time （APTT） were lower than those in healthy control group,while angle（α）,MA,CI and Fib were higher （P<0.05）. After treatment,R,K,PT-INR and APTT were increased,and α,MA,CI and Fib were decreased （P<0.05）. However, compared with healthy control group,after treatment,R,K,PT and PT-INR were still lower,and α,MA,CI and Fib were still higher than those in healthy control group （P<0.05）. In ACI group, the Kappa values of TEG with conventional coagulation tests before and after treatment were 0.072 and 0.124 （P>0.05）,and χ² were 13.40 and 7.60 （P<0.01）. In addition,the results of TEG showed that the platelet hypercoagulabilities before and after treatment were 4.65% and 10.46% in ACI group,the enzymatic hypercoagulabilities were 23.26% and 25.58% ,and the platelet and enzymatic hypercoagulabilities were 40.70% and 15.12%. Conclusions There is a correlation between some indicators of TEG and conventional coagulation tests. Conventional coagulation tests have a certain efficiency on the determination of blood coagulation function in elderly patients with ACI,but the sensitivity is poor compared with TEG. As a sensitive and comprehensive determination of blood coagulation function,TEG is useful for the early determination and clinical treatment of ACI for elderly patients.

Key words: Thromboelastography, Blood coagulation test, Asymptomatic cerebral infarction, Blood coagulation function, Elderly people

CLC Number:

R446.1

LU Jing, ZOU Zhuoru, ZHUANG Guihua. Comparison on thromboelastography and conventional coagulation tests for evaluating blood coagulation function in elderly patients with asymptomatic cerebral infarction[J]. Laboratory Medicine, 2017, 32(8): 663-667.

检测指标	低凝状态	正常	高凝状态
R（min）	>10	5~10	<5
K（min）	>3	1~3	<1
α角（°）	<53	53~72	>72
MA（mm）	<50	50~70	>70
CI	<-3	-3~+3	>+3
PT（s）	>14.5	9.5~14.5	<9.5
PT-INR	>1.5	0.5~1.5	<0.5
APTT（s）	>37	23~37	<23
Fib（g/L）	<2	2~4	>4

检测指标	低凝状态	正常	高凝状态
R（min）	>10	5~10	<5
K（min）	>3	1~3	<1
α角（°）	<53	53~72	>72
MA（mm）	<50	50~70	>70
CI	<-3	-3~+3	>+3
PT（s）	>14.5	9.5~14.5	<9.5
PT-INR	>1.5	0.5~1.5	<0.5
APTT（s）	>37	23~37	<23
Fib（g/L）	<2	2~4	>4

检测指标	R	K	α角	MA	CI
PT	0.887^*	0.064	-0.082	-0.203	-0.326^*
PT-INR	0.869^*	0.002	-0.110	-0.136	-0.333^*
APTT	0.087	0.038	0.018	0.089	0.157
Fib	-0.819^*	-0.010	0.150	0.219^*	0.246^*

检测指标	R	K	α角	MA	CI
PT	0.887^*	0.064	-0.082	-0.203	-0.326^*
PT-INR	0.869^*	0.002	-0.110	-0.136	-0.333^*
APTT	0.087	0.038	0.018	0.089	0.157
Fib	-0.819^*	-0.010	0.150	0.219^*	0.246^*

组别	R	K	α角	MA	CI	PT	PT-INR	APTT	Fib
患者组
治疗前	4.85±1.38^*	1.16±0.26^*	74.24±2.82^*	75.47±4.17^*	3.28±0.69^*	10.38±0.80^*	0.52±0.10^*	30.13±1.24^*	3.60±0.63^*
治疗后	5.51±1.39^*#	1.72±0.31^*#	70.88±3.01^*#	71.97±4.10^*#	2.91±0.67^*#	10.42±0.78^*	0.56±0.11^*#	30.45±1.25^#	3.47±0.61^*#
对照组	6.25±1.13	1.97±0.41	66.72±2.76	67.56±4.34	2.69±0.74	11.66±0.82	0.89±0.11	30.69±1.19	2.55±0.63

Comparison on thromboelastography and conventional coagulation tests for evaluating blood coagulation function in elderly patients with asymptomatic cerebral infarction

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TEG	常规凝血试验
	治疗前			治疗后
	高凝	正常	合计	高凝	正常	合计
高凝	25（29.07）	34（39.53）	59（68.60）	16（18.60）	28（32.56）	44（51.16）
正常	9（10.47）	18（20.93）	27（31.40）	10（11.63）	32（37.21）	42（48.84）
合计	34（39.54）	52（60.46）	86（100.00）	26（30.23）	60（69.77）	86（100.00）

项目	血小板型高凝	凝血因子型高凝	血小板和凝血因子型高凝	合计
治疗前	20（23.26）	4（4.65）	35（40.70）	59（68.60）
治疗后	22（25.26）	9（10.46）	13（15.12）	44（51.16）

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