血栓弹力图评估微炎症状态下腹膜透析患者凝血功能变化的价值-东南大学学报医学版

血栓弹力图评估微炎症状态下腹膜透析患者凝血功能变化的价值

单位：1. 南京医科大学附属南京医院南京市第一医院血透中心, 江苏南京 210006;
2. 东南大学附属中大医院肾内科, 江苏南京 210009

分类号：R318.16

出版年·卷·期（页码）：2015·34·第三期（361-364）

摘要：

目的:利用血栓弹力图研究微炎症状态下持续性不卧床腹膜透析(CAPD)患者凝血功能的变化.方法:选择CAPD患者51例,根据C反应蛋白(CRP)水平分为CRP升高(> 8 mg·L^-1)组和CRP正常(≤8 mg·L^-1)组,对比分析两组血栓弹力图和常规凝血指标的变化.结果:与CRP正常组相比,CRP升高组血栓弹力图反应时间(R)和凝血时间(K)显著缩短(均P <0.05),Angle(α角)、最大血块强度(MA)和综合凝血指数(CI)显著增加(均P <0.05).常规凝血指标在两组间差异无统计学意义(P >0.05).年龄和CRP与CI呈正相关(均P <0.05).多元线性回归分析提示,CRP是CI的独立危险因素(P <0.05).结论:与常规凝血指标相比,血栓弹力图是反映微炎症状态下CAPD患者高凝的一个更为灵敏的指标.

Objective: To investigate the changes of coagulative function in continuous ambulatory peritoneal dialysis(CAPD) patients with micro-inflammatory state by thromboelastograph. Methods: Fifty-one CAPD patients were divided into two groups according to the level of C-reactive protein(CRP), the elevated(> 8 mg·L^-1) and normal(≤8 mg·L^-1) CRP group. The parameters of thromboelastograph and conventional coagulation were compared between the two groups. Results: Compared with the normal CRP group, reactive time(R) and clot formation time(K) were significantly shortened(all P <0.05), while alpha angle(α), maximum amplitude(MA) and clot index(CI) were significantly increased(all P <0.05) in elevated CRP group. The parameters of conventional coagulation had no statistical significance(P >0.05). Age and CRP were positively correlated with CI(all P <0.05). Multivariate linear regression showed that CRP was an independent risk factor of CI(all P <0.05). Conclusions: Compared to conventional coagulation examinations, thromboelastograph is a more sensitive method to reveal the existence of hypercoagulation status in CAPD patients with micro-inflammatory state.

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