Predicative value of thrombelastogram in aSAH with delayed cerebral ischemia
10.3969/j.issn.1002-0152.2018.03.001
- VernacularTitle:血栓弹力图预测aSAH后发生迟发性脑缺血的应用价值
- Author:
Lingjun QI
1
;
Zhijian HUANG
;
Yetao LUO
;
Hui LI
;
Guojing LIU
;
Xiaochuan SUN
Author Information
1. 重庆医科大学附属第一医院神经外科 重庆400016
- Keywords:
Subarachnoid hemorrhage;
Delayed cerebral ischemia;
Coagulation function;
Thrombelastogram
- From:
Chinese Journal of Nervous and Mental Diseases
2018;44(3):129-133
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical value of thrombelastogram (TEG) in prediction for the cause of delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods In this study, there were 30 patients with DCI (group DCI) and 45 patients without DCI (group No-DCI). TEG was performed in all the patients at post-bleeding day 1, 5, 10 and 15 after aSAH(PBDn, n=1,5,10,15). The changes of reaction time (R value), coagulation time (K value),coagulation angle (α value),maximum thrombus consistency (MA value) and coagulation index (CI value) were examined at different time points after aSAH. Results Thirty of 75 aSAH patients developed DCI and the incidence of DCI was 40 percent. According to linear mixed model, both MA value and CI value were significantly statistical different at different time points within each group (P<0.05,for all) as well as between No-DCI group and DCI group.MA value and CI were significantly statistical different at same time point (P<0.05,for all). The results of logistic regression analysis showed that modified Fisher levelⅢ-Ⅳ,△MA5-1(OR=1.124,P=0.024,95% CI=1.015~1.244), PBD5 MA>70(OR=5.605,P=0.011,95% CI=1.464~21.457)were the independent risk factors of DCI.By using ROC curve to define a threshold for prediction of the occurrence of DCI,the rate of DCI was significantly increased when △MA5-1>3.05.Conclusion aSAH Patients, especially those with DCI have severe hypercoagulation. The MA value in PBD5 has an important predictive value for DCI.
