| 陈宏飞,沈肖明,魏权.血栓弹力图在妊娠高血压疾病评估中的应用价值[J].中国医药科学,2025,(1):145-148 基金项目:福建省龙岩市新罗区科技项目（2020XL18-11） |
| 血栓弹力图在妊娠高血压疾病评估中的应用价值 |
| Application value of thromboelastography in evaluation of hypertensive disorders of pregnancy |
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| DOI： |
| 中文关键词: 妊娠期；高血压；血栓弹力图；诊断价值 |
| 英文关键词:Pregnancy; Hypertension; Thromboelastogram; Diagnostic value |
| 作者 | 单位 | | 陈宏飞,沈肖明,魏权 | 福建省龙岩人民医院检验科，福建龙岩 364000 |
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| 中文摘要: |
| [摘要] 目的 探究血栓弹力图（TEG）对妊娠高血压（HDP）疾病的评估价值。 方法 选取2021年9月至2022年9月于福建省龙岩人民医院进行孕检或待产的HDP孕妇作为研究对象（观察组，n=27），选取同期于福建省龙岩人民医院进行孕检或待产的健康孕妇作为对照（对照组，n=63）。收集两组的凝血四项、TEG指标，将对照组的TEG指标与厂商给出的正常参考范围进行比较，观察比较两组的临床资料，分析TEG指标与常规凝血四项指标的相关性，评价TEG指标对HDP的评估价值。 结果 对照组的TEG相关指标及95%可信区间均在正常人群参考值范围内；观察组的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）水平低于对照组，凝血酶时间（TT）高于对照组，差异有统计学意义（均P < 0.05）。观察组的反应时间（R）、凝块形成时间（K）低于对照组，凝固角（α角）、血栓最大幅度（MA）值高于对照组，差异有统计学意义（均P < 0.05）；R与PT（r=0.287，P=0.031）、APTT（r=0.342，P=0.009）呈正相关；α角与FIB呈正相关（r=0.701，P=0.004）；K与FIB呈负相关（r=-0.468，P=0.001）；常规凝血四项指标的曲线下面积（AUC）均小于TEG指标，TEG指标中以MA（AUC=0.814；P=0.003）的评估效能最高。 结论 与常规凝血四项指标相比，TEG指标对HDP的评估更有优势，其中以MA的评估价值最高，故推荐将TEG指标应用于HDP的临床病情评估中。 |
| 英文摘要: |
| [Abstract] Objective To investigate the value of thromboelastography (TEG) in the evaluation of hypertensive disorders of pregnancy (HDP). Methods HDP pregnant women who underwent pregnancy check-up or were waiting for delivery in Longyan People Hospital of Fujian from September 2021 to September 2022 were selected as the research object, and they were divided into the observation group (n=27). Meanwhile, healthy pregnant women who underwent pregnancy check-up or were waiting for delivery in Longyan People Hospital of Fujian during the same period were selected and divided into the control group (n=63). 4 indices of coagulation and TEG were collected from the two groups. The TEG indices of the control group were compared with the normal reference range given by the manufacturer. The clinical data of the two groups were observed and compared. The correlations between TEG indices and conventional 4 indices of coagulation were analyzed to assess the evaluation value of TEG indices for HDP. Results The TEG-related indices and 95% confidence interval of the control group were within the reference value range of the normal population. The levels of prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) in the observation group were lower than those in the control group, while the thrombin time (TT) was higher than that in the control group, with statistically significant differences (all P < 0.05). The reaction time (R) and coagulation time (K) in the observation group were lower than those in the control group, while the coagulation angle (α angle) and the maximum amplitude (MA) of thrombus were higher than those in the control group, with statistically significant differences (all P < 0.05). R was positively correlated with PT (r=0.287, P=0.031) and APTT (r=0.342, P=0.009). The α angle was positively correlated with FIB (r=0.701, P=0.004). There was a negative correlation between K and FIB (r=-0.468, P=0.001). The areas under the curve (AUC) of conventional 4 indices of coagulation were smaller than those of TEG indices, and MA (AUC = 0.814, P < 0.01) had the highest evaluation efficiency in TEG indices. Conclusion Compared with the 4 indices of conventional coagulation, TEG indices have more advantages in evaluating HDP, in which MA has the highest evaluation value, so it is recommended to use TEG indices in evaluating the clinical condition of HDP. |
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