[1]袁 莉,郑 兴,刘德生,等.高原红细胞增多症患者凝血功能检测及临床意义*[J].陕西医学杂志,2020,49(5):623-625.
　YUAN Li,ZHENG Xing,LIU Desheng,et al.Coagulation characteristics of patients with high altitude polycythemia[J].,2020,49(5):623-625.
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高原红细胞增多症患者凝血功能检测及临床意义*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年5期
页码:
623-625
栏目:
临床检验
出版日期:
2020-05-05

文章信息/Info

Title:
Coagulation characteristics of patients with high altitude polycythemia
文章编号:
DOI:10.3969/j.issn.10007377.2020.05.030
作者:
袁 莉; 郑 兴; 刘德生; 王 云△
青海省人民医院(西宁810000)
Author(s):
YUAN Li; ZHENG Xing; LIU Desheng; et al.
Qinghai Provincial People's Hospital(Xining 810000)
关键词:
高原红细胞增多症;  血栓弹力图;  凝血功能;  血小板计数;  相关性
Keywords:
High altitude polycythemia;  Thromboelastogram;  Coagulation function;  Platelet count;  Correlation
分类号:
R555.1
文献标志码:
A
摘要:
目的:通过血栓弹力图(TEG)与常规凝血功能指标的对比分析,探讨高原红细胞增多症(HAPC)患者的凝血特点。方法:择期行胆囊切除术的男性患者78例,术前血红蛋白(HB)均大于120 g/L。根据2004年第六届国际高原医学和低氧生理学术大会制订的高原红细胞增多症的青海诊断标准,慢性缺氧导致机体红细胞过度增生,男性血红蛋白(HB)>210 g/L为高原红细胞增多症组(20例),HB正常患者为对照组(58例)。两组患者术前均接受TEG、常规凝血功能及血小板计数(PLT)检测,比较TEG参数、常规凝血指标及PLT的差异。并对HAPC患者TEG参数与凝血常规指标、PLT进行相关性分析。结果:两组患者部分凝血活酶时间(APTT)、凝血酶时间(TT)、血浆纤维蛋白原(FIB)、D二聚体(DD)、PLT、血细胞凝集块形成时间(K值)、血细胞凝集块形成速率(Angle角)、血凝块最大强度(MA)、凝血综合指数(CI)相比较,差异有统计学意义(P<0.05)。HAPC患者K值与PLT呈负相关; Angle角、MA、CI与PLT呈正相关; TEG参数与常规凝血检测指标无相关性。结论:HAPC患者凝血因子、FIB、血小板数量及功能降低,处于相对低凝的状态; HAPC患者TEG与PLT有显著相关性,与常规凝血功能指标无相关性,TEG联合常规凝血功能检测能更全面、准确地反映机体凝血状态。
Abstract:
Objective:To explore the coagulation characteristics of patients with high altitude polycythemia(HAPC)through the comparative analysis of thromboelastography(TEG)and conventional coagulation indexes. Methods:78 male patients who underwent selective cholecystectomy were selected,and their hemoglobin(HB)was more than 120 g/L before operation. According to the Qinghai diagnostic standard of HAPC formulated by the Sixth International Academic Conference on high altitude medicine and hypoxia physiology in 2004,chronic hypoxia leads to excessive proliferation of red blood cells. The male patients with HB>210 g/L were classified as the high altitude erythrocytosis group(20 cases),and the normal HB patients as the control group(58 cases).The patients in the two groups were tested with TEG,conventional coagulation function and platelet(PLT)count before operation. The differences of TEG parameters,conventional coagulation indexes and PLT were compared,and the correlation between TEG parameters,conventional coagulation indexes and PLT in HAPC patients was analyzed. Results:There were significant differences in partial thromboplastin time(APTT),thrombin time(TT),plasma fibrinogen(FIB),D-Dimer(DD),PLT,blood cell agglutination time(K value),agglutination rate of blood cells(angle),maximum coagulation strength(MA)and coagulation index(CI)between the two groups(P<0.05).In HAPC patients,K value was negatively correlated with PLT; angle,MA,CI were positively correlated with PLT; TEG parameters were not correlated with conventional coagulation test. Conclusion:The number and function of coagulation factor,FIB and PLT in HAPC patients were decreased,and they were in a relatively low coagulation state. There was significant correlation between TEG and PLT in HAPC patients,but no correlation between TEG and conventional coagulation indexes. TEG combined with conventional coagulation function test can more comprehensively and accurately reflect the coagulation state of the body.

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备注/Memo

备注/Memo:
*青海省科技计划项目(2016-ZJ-798)
更新日期/Last Update: 2020-07-28