血栓弹力图与凝血四项评价围生期妇女凝血功能的对比研究

目的探讨血栓弹力图与凝血四项各参数在新疆维吾尔族围生期妇女凝血功能检测中的相关性和一致性,评价2种方法在围生期妇女凝血功能检测方面的应用价值。方法回顾分析3家不同地区医院2018年1月至2018年9月3042例围生期妇女的血栓弹力图、凝血四项和血小板的检测结果,将血栓弹力图的主要参数凝血因子激活时间(R)、血块形成速率参数(K)、弹力图最大切角(Angle角)、弹力图最大振幅(MA)与凝血试验凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及血小板进行相关性分析、Kappa一致性分析和χ2检验分析。结果血栓弹力图与凝血四项各指标之间的差异有统计学意义(P<0.05);围生期妇女中R、PT与APTT呈正相关(r=0.625、0.652,均P<0.05),K值与FIB、血小板呈负相关(r=-0.562、-0.558,均P<0.05),Angle角、MA值与FIB、血小板呈正相关(r=0.605、0.544;0.741、0.508,均P<0.05);R与PT、APTT的Kappa值分别为0.249、0.092(均P<0.05),χ2检验值分别为1868.8、4.0(均P<0.05);K值、Angle角和MA与FIB的Kappa值分别为0.024、0.042、0.103(均P<0.05),χ2检验值分别为133.8、2.0(均P<0.05);K值、Angle角、MA值与血小板的Kappa值分别为0.227、0.205、0.193(均P<0.05),χ2检验值分别为359.8、2.0、0.9(均P<0.05)。结论在维吾尔族围生期妇女中血栓弹力图与凝血四项及血小板的检测显著相关,一致性较弱,2种方法不能互相替代,实际工作需动态监测体内凝血状况,降低患者血栓和输血风险。

A comparative study of thromboelastography and coagulation in evaluating the coagulation function of perinatal women

Objective To investigate the correlation and consistency of the four parameters of thromboelastogram and coagulation in the perinatal maternal coagulation test in Xinjiang Uygur,and to evaluate the application value of two methods in the coagulation test of perinatal women.Methods Retrospective analysis of the results of thromboelastography,four coagulation tests,and platelets in 3 042 perinatal women from January2018 to September 2018 in three perinatal hospitals.The main parameters of thromboelastography were the activation time of clotting factors(R),Blood clot formation rate parameter(K),maximum cut angle of elastic(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and platelets were performed by correlation analysis,Kappa consistency analysis,andχ2 test analysis.Results The differences in thromboelastography and coagulation were statistically significant(P<0.05);R,PT and APTT were positively correlated in the perinatal women′s group(r=0.625,0.652,all P<0.05),K value was negatively correlated with FIB and platelets(r=-0.562,-0.558,all P<0.05),Angle and MA value were positively correlated with FIB and platelet(r=0.605,0.544;0.741,0.508,all P<0.05);The Kappa values of R with PT,APTT were 0.249,0.092(all P<0.05),and theχ2 test values were 1 868.8,4.0(all P<0.05);K values,Angle angles,and MA and Kappa values with FIB were 0.024,0.042,0.103,respectively(all P<0.05),χ2 test values of 133.8,2.0(all P<0.05);K value,Angle angle,MA value and Kappa value with platelets were 0.227,0.205,and 0.193,respectively(all P<0.05),χ2 test values were 359.8,2.0,and 0.9(all P<0.05).Conclusion In Uighur women during perinatal period,thromboelastography is significantly related to blood coagulation test and platelet detection,and the consistency is weak.The two methods can not be replaced with each other.The actual work requires dynamic detection and monitoring of blood coagulation status in the body to reduce the risk of thrombosis and blood transfusion.