中国卒中杂志2016，Vol.11Issue(3)：207-214,8.DOI:10.3969/j.issn.1673-5765.2016.03.009
血栓弹力图凝血酶原通道检测指标在评价急性缺血性脑血管病患者高血小板反应性以及预测复发缺血事件中的价值
Value of Thrombelastography in Predicting the High Platelet Reactivity and Recurrent Ischemic Events of Patients with Acute Ischemic Cerebrovascular Disease
饶子龙 1赵性泉 2陆菁菁 2鞠奕 2方瑞乐 2王文娟 2杨中华 2温淼 2魏娜 2濮月华 2王伊龙 2郑华光 2曹亦宾 1王菲 3王安心 2刘丽萍 2董可辉 2曲辉 2龚浠平 2张倩2
作者信息
- 1. 1063000 唐山华北理工大学附属唐山工人医院神经内科
- 2. 首都医科大学附属北京天坛医院神经病学中心
- 3. 唐山职业技术学院信息工程系
- 折叠
摘要
Abstract
Objective To investigate the value of prothrombin channel detection index from the thrombelastography (TEG) in evaluation of the high platelet reactivity (HPR) and further prediction of recurrent ischemic events. Methods In-patients with acute ischemic cerebrovascular disease who were admitted to Center of Neurology, Beijing Tiantan Hospital, Capital Medical University and eligible for inclusion criteria were continuously enrolled into study. TEG was tested after dual antiplatelet therapy with aspirin and clopidogrel for 5 days. According to platelet inhibition rate in TEG at baseline, the patients were divided into the normal platelet reaction (NPR) group and the high platelet reaction (HPR) group. The prothrombin channel detection indexs from the TEG test were compared between the two groups. Multivariate Logistic regression analysis was used to analyze independent correlative factor for HPR. The recurrent ischemic events were followed up at month 3 and month 6 after discharge from hospital. The association between prothrombin channel detection index from the TEG and recurrent ischemic events was analyzed. Results A total of 374 patients were recruited in the study. Compared with the NPR group (n=287), the patients with HPR group (n=87) had a lower K level (P=0.047), but a higher Angle levels (P=0.026) and maximum amplitude (MA) (P=0.007). Multivariate logistic regression analysis showed that: previous history of ischemic stroke or transient ischemic attack (TIA) (OR 1.723, 95%CI 1.037-2.863,P=0.036) and Angle level (OR 1.090, 95%CI 1.008-1.180,P=0.032) was independently associated with HPR. There were 355 patients who fuliflled the 6 month follow-up, among which, there were 47 cases of recurrent ischemic events. Comparison was made between recurrent ischemic events group (n=47) and non-recurrent ischemic event group (n=308) , and there were no signiifcant differences in the K, Angle, MA and R levels of the endpoint. Conclusion Prothrombin channel detection index from the TEG is helpful to evaluate the HPR in patients with acute ischemic cerebrovascular disease, but a further study is needed to investigate value for TEG in predicting the recurrent ischemic events.关键词
血栓弹力图/急性缺血性脑血管病/高血小板反应性/复发缺血事件Key words
Thrombelastography/Acute ischemic cerebrovascular disease/High platelet reaction/Recurrent ischemic event引用本文复制引用
饶子龙,赵性泉,陆菁菁,鞠奕,方瑞乐,王文娟,杨中华,温淼,魏娜,濮月华,王伊龙,郑华光,曹亦宾,王菲,王安心,刘丽萍,董可辉,曲辉,龚浠平,张倩..血栓弹力图凝血酶原通道检测指标在评价急性缺血性脑血管病患者高血小板反应性以及预测复发缺血事件中的价值[J].中国卒中杂志,2016,11(3):207-214,8.
