【摘要】 目的研究血栓弹力图(TEG)参数与肝硬化患者肝脏储备功能的相关性。方法将2017年1月至2018年5月于陕西省人民医院住院治疗的350例肝硬化患者纳入研究。通过计算其肝功能评分(CTP)和终末期肝病模型(MELD)评分对肝硬化患者肝脏储备功能进行评估。根据CTP分级将肝硬化患者分为ChildA、-B、-C组,对3组的TEG参数进行比较;根据MELD评分将肝硬化患者分为MELD-1组(<15分)、MELD-2组(15～<25分)、MELD-3组(≥25分),对3组的TEG参数进行比较。肝硬化患者TEG参数与CTP、MELD评分之间的相关性采用Spearman等级相关分析。结果随着CTP分级增加,TEG参数中的凝血形成时间(K)逐渐延长,凝固角(α角)、最大振幅(MA)和凝血指数(CI)逐渐减小,3组间比较差异有统计学意义(P<0.05),Child-C、-B组上述指标比较,差异有统计学意义(P<0.05)。随着MELD评分增加,TEG参数中的R、K逐渐延长,α角、MA和CI逐渐减小,3组间比较差异有统计学意义(P<0.05),MELD-2组与MELD-1组间比较,差异均有统计学意义(P<0.05)。R与MELD评分呈正相关(r=0.194,P<0.05),与CTP评分无相关性(r=0.072,P>0.05);K与MELD、CTP评分呈正相关(r=0.194、0.246,均P<0.05);α角、MA、CI与CTP评分均呈负相关(r=-0.219、-0.323、-0.269,P<0.05),与MELD评分也均呈负相关(r=-0.242、-0.322、-0.313,P<0.05)。结论 TEG参数与肝硬化患者肝脏储备功能相关,随着肝脏储备功能的下降,α角、MA、CI逐渐减小,R、K逐渐延长。更多还原

【Abstract】 Objective To study the relationship between thromboelastography(TEG)parameters and liver reserve function in patients with cirrhosis.Methods A total of 350 patients with liver cirrhosis who were hospitalized in Shaanxi Provincial People′s Hospital from January 2017 to May 2018 were enrolled in the study.The liver reserve function of cirrhotic patients was evaluated by Child-Turcotte-Pugh(CTP)and Model for End-stage Liver Disease(MELD).Patients with cirrhosis were divided into Child-A,-B,-C group according to CTP classification,and TEG parameters were compared among the three groups.Meanwhile,patients with cirrhosis were divided into MELD-1 group(MELD scores<15),MELD-2 group(MELD scores 15-<25)and MELD-3 group(MELD scores≥25),then TEG parameters were compared among the three groups.The correlation between TEG parameters and CTP,MELD scores in the cirrhotic patients was analyzed by using Spearman rank correlation analysis.Results K value was gradually prolonged,α-Angle,MA and CI were gradually reduced with the increase of CTP scores;compared among the three groups,the difference were significant(P<0.05);compared between Child-C and-B group the difference was significant(P<0.05).The R and K values were gradually prolonged,whileα-Angle,MA and CI were gradually reduced,with the increase of MELD scores,there was significant difference among the three groups(P<0.05),and the difference between MELD-1 and-2 group was significant(P<0.05).R value was positively correlated with MELD score(r=0.194,P<0.05),but not correlated with CTP score(r=0.072,P>0.05);K value was positively correlated with MELD and CTP score(r=0.194,0.246,P<0.05);α-Angle,MA,CI were negatively correlated with CTP(r=-0.219,-0.323,-0.269,P<0.05)and MELD score(r=-0.242,-0.322,-0.313,P<0.05).Conclusion R value and K value are gradually prolonged,whileα-Angle,MA and CI are gradually reduced with the decline of liver reserve function.The parameters of TEG are correlated with liver reserve function in patients with liver cirrhosis.更多还原