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目的研究血栓弹力图(TEG)对评估流行性出血热(EHF)患者发热早期凝血功能的意义。方法对2015年6月—2016年3月青岛市第六人民医院22例EHF发热早期住院患者的TEG和血凝四项检测结果进行回顾性分析,并与健康对照组比较,评估EHF患者发热早期凝血功能。结果与对照组比较,EHF组患者凝血时间[(6.80±1.80)min]差异无统计学意义(P>0.05),血凝块形成时间[(3.51±1.08)min]上升(P<0.05);Angle值[(51.50±8.27)°]、血块强度[(47.10±5.98)mm]、凝血综合指数(-3.86±2.69)和血小板(PLT)计数[(56.95±25.38)×109/L]下降(均P<0.05);血凝四项中纤维蛋白原[(3.46±1.06)g/L]、凝血酶原时间[(10.88±1.07)s]、活化凝血酶时间[(33.90±9.79)s]和凝血酶时间[(14.55±1.56)s]差异均无统计学意义(P>0.05)。结论 EHF患者发热早期总体处于凝血功能降低状态,PLT功能降低;TEG较常规血凝四项更能敏感地反映EHF患者发热早期体内凝血情况。
Objective To investigate the significance of thromboelastography (TEG) in assessing early febrile clotting in patients with epidemic hemorrhagic fever (EHF). Methods Twenty-four patients with early EHF fever in hospital in Qingdao Sixth People’s Hospital from June 2015 to March 2016 were retrospectively analyzed for TEG and blood coagulation. Compared with the healthy control group, the results of early detection of fever in EHF patients Coagulation. Results Compared with the control group, the clotting time in EHF group [(6.80 ± 1.80) min] was not significantly different (P> 0.05), and the clot formation time was (3.51 ± 1.08) min in the EHF group (P <0.05). (51.50 ± 8.27) °, blood clot strength (47.10 ± 5.98) mm, coagulation index (-3.86 ± 2.69) and platelet count (56.95 ± 25.38) × 109 / L (P <0.05). The levels of fibrinogen (3.46 ± 1.06 g / L), prothrombin time [(10.88 ± 1.07) s] and activated thrombin time in the four blood coagulation groups (33.90 ± 9.79 s) And thrombin time [(14.55 ± 1.56) s], there was no significant difference (P> 0.05). Conclusions EHF patients generally have an early onset of hypothyroidism with decreased blood coagulation and PLT. TEGs more sensitively reflect the early onset of coagulation in EHF patients than those with conventional hemagglutination.