欣维宁修饰的血栓弹力图和血纤维蛋白原浓度的相关性研究.docVIP

欣维宁修饰的血栓弹力图与血纤维蛋白原浓度的相关性研究 陆志强 南京医科大学第二附属医院麻醉科 210011 【摘要】 目的 探讨体外循环手术中欣维宁修饰的血栓弹力图（TEG）参数最大振幅（MA）与血浆纤维蛋白原浓度的相关性。 方法 对50例瓣膜置换病人在术前、复温后、鱼精蛋白中和后三个时间点分别用标准TEG和欣维宁修饰的TEG进行对比检测，同时检测血小板计数、纤维蛋白原浓度。 结果 标准TEG的MA和欣维宁修饰的MA分别与血浆纤维蛋白原浓度呈显著正相关(r2=0.5，p0.01；r2=0.8，p0.01)。标准MA和欣维宁修饰的MA的差值△MA和血小板计数相关性无统计学意义(r2=0.04，p=0.73),当△MA采用剪切模数差异△GMA来评估时，△GMA与血小板计数呈显著正相关(r2=0.51，p0.01)。 结论 虽然两种TEG的MA与血浆纤维蛋白原浓度均呈正相关，但欣维宁修饰的TEG的MA评估纤维蛋白原浓度的精确性更高。 【关键词】 血栓弹力图；欣维宁；心肺转流 The correlation of tirofiban-modified thromboelastography with fibrinogen level in patients undergoing cardiopulmonary bypass Lu Zhiqiang , Chen Yu , LIANG yong-nian , et al.Department of Anesthesiology , First Affiliated Hospital , Nanjing Medical University , Nanjing 210029 , china 【Abstract】 Objective To investigation the correlation of tirofiban-modified thromboelastography’s MA with plasma fibrinogen level during cardiopulmonary bypass（CPB）.Methods Fifty consecutive patients scheduled for selective valve replacement under CPB were investigated. Measurements were performed at three time points of before operation, rewarming on CPB , and after protamine administration with standard TEG , tirofiban-modified TEG and laboratory coagulation testing respectively. Laboratory coagulation testing in all patients included a platelet count and fibrinogen level. Results The correlation between plasma fibrinogen levels and standard MA was significant (r2=0.5,p0.01).Correlation between plasma fibrinogen levels and tirofiban-modified MA was significant (r2=0.8,p0.01).Correlation of △MA with platelet count was not significant when calculated in millimeters (r2=0.04,p=0.73). However, when △MA was calculated with the difference of elastic shear modulus (△GMA), it correlated significantly with platelet count (r2=0.51,p0.01). Conclusion The correlation between standard MA and plasma fibrinogen levels was similar to that between tirofiban-modified MA and plasma fibrinogen levels. However, tirofian-modified MA showed