血栓弹力图对急性白血病患者出血风险的预测价值研究

目的：探讨血栓弹力图（T EG ）在急性白血病患者出血风险的评估及诊断价值中的作用。方法通过对127例急性白血病患者进行数据统计（共272组有效统计数据），将所有数据按临床有无出血分组（出血组、无出血组），比较两组T EG的4项指标反应时间（R）、血凝块形成时间（K）、α角、最大振幅（MA）]和血小板（PLT）计数。对PLT＜30×109个／L者，按有无出血分组（有出血组、无出血组）并比较T EG的4项指标。通过ROC曲线，比较T EG不同指标与PL T计数评估出血风险的准确性与特异性。结果所有272组数据比较，出血组K值、R值大于无出血组，α角、M A值、PL T 计数小于无出血组（ P＜0．05）；PL T＜30×109个／L的急性白血病患者，出血组K值大于无出血组，α角、M A小于无出血组（ P＜0．05），两组R值、PL T计数差异无统计学意义（P＞0．05）；PLT计数、MA值、α角诊断出血的ROC曲线下面积均大于0．5（分别为0．750、0．740、0．653）。结论 TEG能够预测急性白血病出血风险，有较好的临床实用性。

The value of thromboelastography in evaluating the risk of bleeding in patients with acute leukemia

Objective To investigate the role of thrombelastography(TEG) in assessing the risk of bleeding and diagnostic value in patients with acute leukemia(AL) .Methods The TEG and PLT data were counted in 127 patients(272 sets of data) who were diagnosed with AL .Those patients were divided into two groups :group 1 (including patients with bleeding) and group 2 (in‐cluding patients with no bleeding) .The indicators(R values ,K values ,α‐angle ,MA values)and PLT count were compared between two groups .Those data with PLT<30 × 109/L of these two groups also were divided and the 4 indicators of TEG were compared between the two groups .We used the ROC curve to evaluate the sensitivity and specificity in assessing the risk of bleeding .Results According to the data in total ,the K value ,R value of the group 1 were higher than those of the group 2(P<0 .05);theα‐angle and MA value ,PLT counts of group 1 were lower than those of the group 2(P<0 .05) .In those AL patients whose PLT<30 × 109/L ,the K value of the group 1 was higher than that of the group 2(P<0 .05);theα‐Angle and MA value of the group 1 were lower than those of the group 2(P<0 .05);R values and PLT count were not different between the two groups(P>0 .05);the are‐as under the ROC curve about the PLT counts ,MA value andα‐angle were more than 0 .5 (0 .750 ,0 .740 and 0 .653) .Conclusion T EG could predict the risk of bleeding in acute leukemia patients and it could be used in clinical application .