摘要
目的探究血栓弹力图(TEG)对门静脉血栓(PVT)的预测价值。方法选取2008年1月至2021年9月重庆医科大学附属第二医院住院的满足纳入标准的179例肝硬化患者为研究对象,收集临床病例资料,根据是否伴发PVT分为PVT组(87例)和无PVT组(92例),采用二元logistics回归模型分析影响PVT的危险因素,并纳入受试者工作特征(ROC)曲线及曲线下面积(AUC)评估预测价值。结果与无PVT组比较,PVT组终末期肝病血清钠模型(MELD-NA)评分、Child-pugh评分、国际化标准比值(INR)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)水平更高,血小板计数、凝血酶原活动度(PTA)、纤维蛋白原(FIB)水平更低,凝血速率反应时间(K值)更大,最大振幅(MA)更小,差异有统计学意义(P<0.05)。总胆红素、直接胆红素、MA、MELD-NA评分、Child-Pugh评分为肝硬化伴PVT的影响因素(P<0.05)。MA、MELD-NA评分、MA联合MELD-NA评分的AUC两两比较,差异无统计学意义(P>0.05)。结论TEG中的MA降低为肝硬化伴PVT的独立危险因素,可以较好地预测PVT形成。
Objective To evaluate the predictive value of the thromboelastography(TEG)in the portal vein thrombosis(PVT)patients.Methods A total of 179 cirrhosis patients,who met the inclusion criteria and were admitted to the Second Affiliated Hospital of Chongqing Medical University from January 2008 to September 2021,were enrolled.The clinical data were collected.The patients were divided into the PVT group(n=87)and the non-PVT group(n=92).The binary logistic regression analysis was used to analyze the risk factors affecting PVT and the receiver operating characteristic(ROC)curve and area under the curve(AUC)were included to evaluate the predictive value.Results Compared with those of the non-PVT group,the PVT group had higher model for end-stage liver disease sodium(MELD-NA)score,Child-pugh score,international normalized ratio(INR),prothrombin time(PT)and activated partial thromboplastin time(APTT)levels,lower levels of platelet count,prothrombin activity(PTA),fibrinogen(FIB),higher K-time(K value)and lower maximum amplitude(MA),and the differences were statistically significant(P<0.05).The total bilirubin,direct bilirubin,MA,MELD-NA score and Child-Pugh score were the influencing factors of cirrhosis with PVT(P<0.05).There was no significant difference between AUC of MA,MELD-NA score and MA combined with MELD-NA score(P>0.05).Conclusion The decrease of MA is an independent factor of PVT formation,with a certain predictive value for cirrhosis with PVT.
作者
徐君茹
陈科利
高建
XU Junru;CEHN Keli;GAO Jian(Department of Gastroenterology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of Gastroenterology,Mianyang Third People’s Hospital,Mianyang,Sichuan 621000,China)
出处
《重庆医学》
CAS
2022年第17期2955-2960,共6页
Chongqing medicine
基金
重庆市科委基础研究与前沿探索项目(cstc2018jcyjAX0181)。
关键词
血栓弹力图
最大振幅
肝硬化
血栓
终末期肝病血清钠模型评分
thromboelastography
maximum amplitude
cirrhosis
thrombosis
model for end-stage liver disease sodium score
