ABSTRACT
【Objective】 To determine the reference range of thromboelastogram(TEG) and establish a TEG feature for local population by measuring TEG parameters in healthy adults in Shenzhen comparing the difference between gender and age, and analyzing the reference data provided by reagent manufacturer. 【Methods】 A total of 916 healthy adults, aged between 19 to 59, who did their regular health checks in our hospital from September 2020 to August 2021 were selected. The TEG(from Lepu Medical Technology Co., Ltd.) was performed, and the clot reaction time(R), clot formation time(K), coagulation angle(α-Angle), maximum amplitude(MA), coagulation index(CI), fibrinolysis index LY30 and the estimated percent lysis (EPL) were analyzed. 【Results】 The reference ranges of TEG parameters, including R, K, α-Angle, MA, CI, LY30 and EPL, of 916 healthy adults from Shenzhen were 3.25~8.19 min, 0.66~3.18min, 47.70~76.56deg, 50.05~72.91mm, -4.3~3.4, 0~2.2% and 0~3%, respectively. The value of α-Angle, CI, K, LY30, MA and R didn’t all meet the given range provided by the manufacturer; some were exceeding and some inferior to. A total of 227 out of 916 individuals presented abnormal results, relative to the references, in at least one parameter, and 78 were diagnosed of abnormal coagulation based on the given reference range, with a specificity of 75.2%. 【Conclusion】 The reference range of TEG parameters of Shenzhen locals is significantly different from that provided by manufacturers. And it is imperative for local TEG laboratories to establish their own reference ranges according to age and gender groups based on local population characteristics.
ABSTRACT
【Objective】 To analyze the correlation between thromboelastogram(TEG) index and postoperative bleeding in patients underwent percutaneous nephrolithotomy, thus providing evidence for clinical treatment and prevention. 【Methods】 The clinical data of 90 patients suffered from percutaneous nephrolithotomy were collected for a retrospective study. According to the presence or absence of bleeding, they were divided into non-bleeding group (n=71) and bleeding group (n=19).1) The clinical data, including gender, age, operation time, glomerular filtration rate (GFR), stone length, stone width, stone CT value, white blood cell count (WBC), hemoglobin (Hb), platelet count (Plt), neutrophil ratio, prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), D2 polymer, procalcitonin (PCT), interleukin-6 (IL-6), and TEG indicators (R value, K value, MA value, and angle), of the bleeding group and the non-bleeding group were compared. 2) The risk factors of postoperative bleeding in patients underwent percutaneous nephrolithotomy were analyzed. 3) The K, MA, R value, angle and ROC curve of the combined index were analyzed. 【Results】 There was no significant difference in gender, age, operation time, stone length, stone width, WBC, Plt, neutrophil ratio, PT, INR, APTT, R value between the two groups (P>0.05). General data of the two groups, including GFR, CT value of stones, Hb, D2 polymer, PCT, IL-6, K value, MA value, and angle, were statistically different (P0.05), 0.303 of Youden index, 89.50% of sensitivity, and 40.80% of specificity; AUC value of angle: (0.720, P0.05), 0.377 of Youden index, 84.20% of sensitivity, and 53.50% of specificity; AUC value of the combined index: (0.696, P<0.05), 0.384 of Youden index, 94.70% of sensitivity, and 43.70% of specificity. 【Conclusion】 TEG indicators can assess the coagulation function of patients underwent percutaneous nephrolithotomy, predict the risk of postoperative bleeding, and help guide clinical postoperative treatment.
ABSTRACT
【Objective】 To explore the clinical value of thromboelastogram (TEG) in monitoring coagulation function in patients with COVID-19. 【Methods】 Patients diagnosed with COVID-19 in our hospital from January 20 to March 1, 2020 were enrolled and divided into mild group (mild type, common type) and severe group (severe type, critical group). The TEG, platelet count and routine blood coagulation function were compared between the two groups to analyze the coagulation characteristics of the patients. 【Results】 A total of 66 cases were studied, including severe (n=33) and mild (n=33), male(n=39)and female(n=27), hypertension (n=9) and diabetes mellitus (n=11) cases. 28 (84.8%) severe and 24 (72.7%) mild patients had at least one hypercoagulable TEG parameter. K value of TEG in the severe group was lower than that in the mild group (P<0.05), Angel and CI increased (P<0.05). The fibrinogen (Fib) and D-dimer increased in routine coagulation function test (P<0.05). 【Conclusion】 Patients with COVID-19 showed hypercoagulability in TEG parameter, which was related to the severity of this disease. TEG may be more valuable for COVID-19 patients with hypercoagulable status and thrombosis risk, and help to develop anticoagulation strategies.
ABSTRACT
【Objective】 To explore the value of thromboelastogram (TEG) in evaluating coagulation function of patients with liver cancer. 【Methods】 102 patients with liver cancer and 48 with hepatic hemangioma from Department of Hepatobiliary Surgery, Nanyang Central Hospital from August 2017 to September 2020 were retrospectively analyzed. TEG indicators (R, K, Angle, MA, CI, and G value) and routine coagulation indicators (Plt, PT, INR, APTT, FIB, and TT) of those patients and basic clinical data of liver cancer patients were collected, and the difference of detection parameters between the liver cancer group and liver hemangioma group was compared; The difference of TEG parameters in liver cancer patient subgroups was compared, and the correlation between TEG and routine coagulation tests in liver cancer patients was analyzed using Spearman rank correlation analysis. The sensitivity of the two detection methods in detecting the coagulation status of patients with liver cancer was compared. 【Results】 1) Compared with patients with hepatic hemangioma, Plts decreased significantly (166.6±108.824 vs 224.10±54.933, P<0.001), while PT, INR and APTT values increased significantly (13.12±2.052 vs 11.421±0.884, 1.156±0.191 vs 1.00±0.074, 29.977±5.333 vs 26.954±5.269, all P<0.05) in patients with liver cancer; MA and G values in patients with liver cancer were lower (56.991±11.574 vs 60.069±5.094, 7.667±4.682 vs 7.725±1.709, P<0.05); 2) Compared with newly diagnosed liver cancer patients, the Plt of re-diagnosed liver cancer patients decreased significantly(125.78±79.673 vs 188.86±116.437, P<0.05); the R and K value increased significantly (7.594±2.601 vs 6.058±1.739, 3.453±2.402 vs 2.438±1.990, all P<0.05), while the Angle, MA, CI and G value decreased significantly (53.897±12.288 vs 61.495±9.949, 53.556±11.407 vs 58.865±11.313, -3.494±4.253vs -0.836±3.180, 6.311±3.209 vs 8.406±5.191, all P<0.05); 3) There were significant differences in TEG parameters (R value excluded) between liver resection, transhepatic arterial chemoembolization and conservative treatment (P<0.05); 4) The R, K value of patients with liver cancer were negatively correlated with the Plt value, while the Angle, MA, CI, and G value were positively correlated with Plt value (P<0.001); the K value was negatively correlated with the Fib value, while the Angle, MA, CI, G value were positively correlated with Fib value (P<0.001); the R and K value were positively correlated with TT value, while the Angle and CI were negatively correlated with TT value (P<0.05); 5) The detection rate of hypocoagulability by TEG and routine coagulation testing was 18.63% (19/102) and 7.84%. 【Conclusion】 Compared with the newly diagnosed liver cancer patients, re-diagnosed liver cancer patients showed hypercoagulability. TEG can diagnose the coagulation abnormalties more sensitively, and help reduce the risk of bleeding.
ABSTRACT
【Objective】 To observe the characteristics and correlation analysis of thromboelastogram (TEG) and platelet related indexes in patients with preeclampsia in late pregnancy. 【Methods】 88 patients with preeclampsia in late pregnancy treated in the Obstetrics Department of Shanghai Ninth People′s Hospital (Northern Hospital) from June 2017 to June 2020 were selected as observation group, and 288 normal pregnant women in late pregnancy with normal prenatal examination were selected as the control. The median elbow vein blood of the two groups were sampled. The TEG and coagulation related indexes of the two groups were compared, and the relationship between TEG and coagulation related indexes in patients with preeclampsia were analyzed. 【Results】 The K, MA, TT, INR and PLT value in the observation group, relative to controls, were significantly higher (P<0.01), but Angle, PT, and APTT value were significantly lower (P<0.01). The variance K and MA were negatively correlated with PT and APTT (P<0.05), but positively correlated with TT, INR and Plt (P<0.05). Angle was positively correlated with PT and APTT (P<0.05), but negatively correlated with TT, INR and Plt(P<0.05). 【Conclusion】 Routine TEG detection can effectively evaluate the coagulation state of patients with preeclampsia, who are often accompanied by coagulation dysfunction, help to guide clinical early prevention and intervention, and reduce the risk of perinatal hemorrhage and embolism diseases, which is worthy of popularizing in clinical.