国际神经病学神经外科学杂志2024，Vol.51Issue(4)：16-22,7.DOI:10.16636/j.cnki.jinn.1673-2642.2024.04.003
血栓弹力图与脑白质病变相关性及其诊断价值研究
Association between thromboelastography and white matter lesions and its diagnostic value
摘要
Abstract
Objective To investigate the association of coagulation function measured by thromboelastography(TEG)with white matter lesions.Methods A cross-sectional study was conducted among 109 patients with acute ischemic stroke who were consecutively admitted to Department of Encephalopathy,The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine(West Campus),from August 2022 to December 2023.According to the modified Fazekas scale,the patients were divided into grade 0,1,2,and 3 groups,and general clinical data and TEG parameters were compared between groups.A univariate ordinal regression analysis was used to investigate the correlation between various factors and white matter hyperintensity,and a stepwise bidirectional ordinal regression analysis was conducted separately on general clinical data or general clinical data combined with TEG parameters to identify different model features and establish a logistic regression model.The receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve were used to evaluate the value of general clinical data combined with TEG parameters in the diagnosis of white matter hyperintensity(Fazekas grade≥2)in patients with ischemic stroke.Results There were significant differences among the four groups in age,hypertension,history of stroke,and the TEG parameters of maximum amplitude(MA),Angle,and coagulation index(CI)(P＜0.05).The univariate ordinal regression analysis showed that age,hypertension,history of stroke,and the TEG parameters of MA,Angle,and CI were risk factors for the increase in modified Fazekas grade(P＜0.05).Compared with the model based on general clinical data,the model based on general clinical data and TEG parameters had a larger area under the ROC curve and a higher Youden index.Conclusions The TEG parameters of MA,Angle,and CI are correlated with the modified Fazekas grade that reflects white matter lesions in patients with ischemic stroke,which has important guiding significance for the rapid diagnosis and evaluation of the extent of white matter lesions.关键词
缺血性脑卒中/血栓弹力图/脑白质高信号/诊断模型Key words
ischemic stroke/thromboelastography/white matter hyperintensity/diagnostic model分类
医药卫生引用本文复制引用
夏敏,王建力,吴岱宗,高雪飞,龚伟,余能伟,黄国祥..血栓弹力图与脑白质病变相关性及其诊断价值研究[J].国际神经病学神经外科学杂志,2024,51(4):16-22,7.基金项目
成都市卫健委2022年医学研究课题(2022231) （2022231）
成都中医药大学"杏林学者"学科人才科研提升计划医院专项(YYZX2022088). （YYZX2022088）
