血栓弹力图评价冠心病合并高血压患者血栓风险的价值

摘要

目的:观察血栓弹力图评价冠心病合并高血压病患者血栓风险的价值.方法:选择我院收治的120例冠心病(CHD)患者,按照是否有合并高血压分为单纯CHD组(58例)与CHD合并高血压组(62例),比较两组患者的血栓弹力图指标程度.结果:与单纯CHD组比较,CHD合并高血压组血凝块形成时间[K:(2.53±0.72)min比(1.82±0.64)min]、凝血反应时间[R:(8.66±1.86)min比(7.18±1.85)min]、花生四烯酸通道诱导的血小板活性[AA:(57.36±16.91)%比(46.73±20.73)%]明显减少,血块形成后最大振幅[MA:(57.31±7.75)mm比(64.36±7.85)mm]、从血凝块形成点至描记图最大曲线弧度作切线与水平线的夹角值[Angle:(53.26±7.78)°比(64.38±7.85)°]明显增加(P均<0.01).Spearman相关分析显示,CHD合并高血压患者血压水平与Angle、MA成明显正相关(r=0.607、0.405,P均<0.01),与R、K成明显负相关(r=-0.256、-0.541,P均<0.01).结论:对于冠心病合并高血压患者来说血栓形成具有更高风险,更容易引发急性心血管事件,因此应重视冠心病合并高血压患者凝血功能的监测,预防心脏不良事件的发生.%Objective: To observe assessment effects of thromboelastogram (TEG) on patients with coronary heart disease (CHD) complicated hypertension.Methods: A total of 120 CHD patients were selected from our hospital.According to complicated with hypertension or not, they were divided into pure CHD group (n=58) and CHD + hypertension group (n=62).TEG indexes were compared between two groups.Results: Compared with pure CHD group, there were significant reductions in blood clot formation duration [K: (2.53±0.72)min vs.(1.82±0.64)min], coagulation reaction duration [R: (8.66±1.86)min vs.(7.18±1.85)min], arachidonic acid pathway-induced platelet activity [AA: (57.36±16.91)% vs.(46.73±20.73)%], and significant rise in maximum amplitude after clot formation [MA: (57.31±7.75)mm vs.(64.36±7.85)mm] and included angle value between the tangent from the blood clot forming point to the maximum curve radian of the chart and the horizontal line [Angle: (53.26±7.78) vs.(64.38±7.85)] in CHD + hypertension group, P<0.01 all.Spearman correlation analysis indicated that blood pressure level was significantly positive correlated with Angle and MA (r=0.607, 0.405, P<0.01 both), and significantly inversely correlated with R and K (r=-0.256,-0.541, P<0.01 both) in CHD + hypertension patients.Conclusion:Thrombosis possesses higher risk for CHD + hypertension patients, which is easier to cause acute cardiovascular events.Therefore, attention should be paid to coagulation function monitoring in order to prevent adverse cardiac events in these patients.