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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血栓造影（TEG）对肾功能不全和脑出血（ICH）患者的凝血功能进行量化。方法：我们回顾了2009年11月至2015年5月期间收治的自发性脑出血患者。TEG在入院时进行。肌酐清除率（CCr）采用Cockroft-Gault方程计算。根据肾功能正常（CCr；=90）或降低（CCr；90），将患者分为2组。采用多变量回归模型比较三甘醇组分的差异。结果：共有120名患者被纳入分析。与肾功能减退组相比，正常CCr组更年轻（56.1岁对62.3岁，P；01），男性更常见（73.6%对53.7%，P=0.03），平均入院血红蛋白更高（14.2对13.2 mEq/L，P；01）。两组在抗血小板或抗凝剂的使用、凝血研究和基线ICH容量方面相似。经过多变量分析，发现与正常组相比，肾功能减退组的K值较短（1.5对2.2分钟，P=004），角度增加（66对62.2度，P=0.04），MA值增加（67.3对62.3，P=0.02），G值增加（11.3对9达因/cm（2），P=0.04）。两组之间的死亡率、功能不良结果（改良Rankin评分4-6）、血肿扩大、住院时间和手术干预无差异。结论：ICH和CCr降低的患者显示出更快的凝血速度和更高的凝血强度，这表明肾功能不全患者根据被认为反映血小板活性的TEG参数表现出相对高凝状态。（c） 2018年全国中风协会。爱思唯尔公司出版。版权所有。

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