Objective To establish the reference intervals of rapid thrombelastography(rTEG) and Kaolin thrombelastography(CK-TEG) in children,and to evaluate their correlations with traditional coagulation tests and the role of CK-TEG among children with hemophilia. Methods A total of 242 children undergoing elective surgery,40 healthy adults and 42 children with hemophilia were enrolled,and rTEG,CK-TEG and traditional coagulation tests were performed. All children were classified into <1 month old,1 month old-1 year old,2-5 years old,6-10 years old and 11-16 years old groups .Results Compared with adults,children exhibited more hypercoagulation according to rTEG and CK-TEG parameters(high Angle,MA and G and short K)(P<0.05), and these 4 parameters were also correlated with platelet(PLT) and fibrinogen(Fib)(P<0.05). In addition, ACT,R and LY30 were correlated with prothrombin time(PT),activated partial thromboplastin time(APTT) and D-dimer(DD)(P<0.05). All CK-TEG parameters were abnormal for children with hemophilia,and R with factor inhibitor was higher than that without factor inhibitor(P<0.05).Conclusions The parameters of thrombelastography could reflect the levels of PLT,Fib,coagulation activity and fibrinolysis,and it is helpful to screen coagulation factor inhibitor for children with hemophilia.%目的 建立儿童快速血栓弹力图试验(rTEG)及高岭土血栓弹力图试验(CK-TEG)的参考区间,评价其与常规凝血项目的相关性,并了解CK-TEG在血友病患儿中的应用价值.方法 选取242例择期手术儿童、40名健康成人及42例血友病患儿,分别检测其CK-TEG、rTEG及常规凝血项目,儿童按<1个月、1个月~1岁、2~5岁、6~10岁及11~16岁分为4个年龄段.结果 rTEG及CK-TEG参数提示各年龄段儿童较成人偏高凝:Angle、MA、G显著增高(P<0.05),K显著缩短(P<0.05),并与血小板(PLT)、纤维蛋白原(Fib)水平明显相关(P<0.05);ACT、R、LY30分别与凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)明显相关(P<0.05).血友病患儿CK-TEG各参数均明显异常,存在因子抑制物的患儿的R值明显高于无因子抑制物患儿(P<0.05).结论 血栓弹力图各参数可反映PLT水平、内外源凝血活性、Fib功能及纤溶活性,并有助于筛选存在因子抑制物的血友病患儿.
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