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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Thrombelastography Suggests Hypercoagulability in Patients with Renal Dysfunction and Intracerebral Hemorrhage
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Thrombelastography Suggests Hypercoagulability in Patients with Renal Dysfunction and Intracerebral Hemorrhage

机译：血栓塑料表明肾功能障碍和脑内出血患者的高凝率

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Background: The objective of this study was to quantify coagulopathy using thrombelastography (TEG) in patients with renal dysfunction and intracerebral hemorrhage (ICH). Methods: We reviewed patients admitted with spontaneous ICH between November 2009 and May 2015. TEG was performed at the time of admission. Creatinine clearance (CCr) was calculated using the Cockroft-Gault equation. Patients were divided into 2 groups based on normal (CCr = 90) or reduced renal function (CCr 90). Multivariable regression models were conducted to compare the differences of TEG components. Results: A total of 120 patients were included in the analysis. The normal CCr group was younger (56.1 versus 62.3 years, P .01), was more often male (73.6% versus 53.7%, P =.03), and had higher mean admission hemoglobin (14.2 versus 13.2 mEq/L, P .01) than the reduced renal function group. The 2 groups were similar with respect to antiplatelet or anticoagulant use, coagulation studies, and baseline ICH volume. Following multivariate analysis, the reduced renal function group was found to have shorter K (1.5 versus 2.2 min, P = 004), increased angle (66 versus 62.2 degrees, P =.04), increased MA (67.3 versus 62.3, P =.02), and increased G (11.3 versus 9.9 dynes/cm(2), P =.04) compared with the normal group. Mortality, poor functional outcome (modified Rankin Scale score 4-6), hematoma enlargement, hospital length of stay, and surgical interventions were not different between the 2 groups. Conclusions: Patients with ICH and reduced CCr display faster clotting rate and increased clot strength, suggesting that patients with renal dysfunction present with a relatively hypercoagulable state based on TEG parameters thought to reflect platelet activity. (c) 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.
机译：背景：本研究的目的是使用肾功能紊乱和脑内出血（ICH）患者使用血栓形成（TEG）量化凝血病变。方法：我们审查了2009年11月至2015年5月在2009年11月间自发ICH录取的患者。TEG在入场时进行。使用Cockroft-Gault方程计算肌酐清除（CCR）。基于正常（CCR＆ = 90）或肾功能降低（CCR <90），患者分为2组。进行多变量回归模型以比较TEG组件的差异。结果：分析中共有120名患者。正常的CCR组较年轻（56.1与62.3岁，P＆ .01）较高，雄性较高（73.6％，53.7％，p = .03），具有更高的平均入学血红蛋白（14.2与13.2 Meq / L， P＆ 01）比肾功能缩减。对于抗血小板或抗凝血剂使用，凝血研究和基线ICH体积相似。多变量分析后，发现还原肾功能组具有较短的k（1.5与2.2分钟，P = 004），增加角度（66与62.2度，p = .04），增加MA（67.3与62.3，P =。与正常组相比，02），增加G（11.3与9.9达因/ cm（2），p = .04）。死亡率，功能性差异差（改进的Rankin Scade 4-6），血肿扩大，医院住院时间和手术干预措施在2组之间没有差异。结论：ICH和CCR减少的患者显示器更快，凝块强度增加，提高肾功能障碍的患者存在于基于TEG参数的相对高古凝固的状态，以反映血小板活性。 （c）2018国家冲程协会。由elsevier Inc.保留所有权利发布。

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