Correlation between the early coagulation function and delayed cerebral ischemia after aSAH

Mao Lei; Yuan Yuqing; Cheng Chongjie; Wu Jingchuan; Chai Weina; Jiang Dengzhi; Zhang Xiaodong; Sun Xiaochuan

doi:10.13406/j.cnki.cyxb.001438

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Correlation between the early coagulation function and delayed cerebral ischemia after aSAH

更新时间：2024-01-17

- Correlation between the early coagulation function and delayed cerebral ischemia after aSAH
- Journal of Chongqing Medical University Vol. 42, Issue 12, Pages: 1631-1634(2017)
- 作者机构：
  
  1. 重庆医科大学附属第一医院神经外科
  2. 成都市第三人民医院神经外科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001438
  CLC： R743
- Published：2017，
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Mao Lei, Yuan Yuqing, Cheng Chongjie, et al. Correlation between the early coagulation function and delayed cerebral ischemia after aSAH. [J]. Journal of Chongqing Medical University 42(12):1631-1634(2017)
DOI：

Mao Lei, Yuan Yuqing, Cheng Chongjie, et al. Correlation between the early coagulation function and delayed cerebral ischemia after aSAH. [J]. Journal of Chongqing Medical University 42(12):1631-1634(2017) DOI： 10.13406/j.cnki.cyxb.001438.

摘要

目的:探讨动脉瘤性蛛网膜下腔出血（aneurysmalsubarachnoid hemorrhage

aSAH）后早期凝血功能各参数变化与迟发性脑缺血（delayed cerebral ischemia

DCI）的相关性

为临床上早期预测及干预迟发性脑缺血提供依据。方法:回顾性分析77例aSAH患者发病24 h内的凝血象和血栓弹力图（thromboelastography

TEG）参数

同期收集22例未破裂动脉瘤（unruptured intracranial aneurysm

UIA）患者作为对照。根据是否发生DCI将aSAH患者分为DCI组（n=38）和No-DCI组（n=39）

比较2组间一般资料、凝血象和TEG参数的差异

多因素logistic回归分析确定危险因素。结果:与No-DCI组比较

DCI组患者D-D、FDP、Fib、α角、MA值明显升高（P=0.000、0.000、0.000、0.043、0.042）

R和K值明显降低（P=0.002、0.036）;多因素分析显示D-D（OR=9.739

95%CI=1.896

0.042

P=0.006）、K值（OR=0.026

P=0.028

95%CI=0.01

.681）为DCI的独立危险因素。结论:aSAH患者早期D-D、FDP、Fib、α角、MA值明显升高

R、K值下降

与DCI的发生存在相关性

其中D-D与K值为aSAH后发生DCI独立危险因素。因此

早期监测凝血功能有助于预测DCI的发生

并指导相应处理。

Abstract

Objective:To investigate the correlation between the parameter of early coagulation function and the incidence of delayed cerebral ischemia after subarachnoid hemorrhage and to provide basis of early prediction and intervention for delayed cerebral ischemia in clinical treatment.Methods:The coagulation and TEG of 77 patients with aSAH within 24 hours from onset was analyzed retrospectively and 22 cases of unruptured aneurysms（UIA）were collected as matched group.aSAH patients were divided into the DCI group（38 cases）and No-DCI group（39 cases）to compare the clinical data

coagulogram and parameter of TEG.The multi-factor logistic regression analysis was adopted to determine the risk factors.Results:Compared with those of the No-DCI group

the values of DD

FDP

Fib

α and MA in DCI group were significantly higher（P=0.000

0.000

0.043

0.042）

while values of R and K were lower（P=0.002

0.036）.The result of multiple-factor analysis shows that the parameter of D-D and K were the independent risk factors.Conclusion:The parameter of D-D

FDP

Fib

α angle

MA is significantly increased

while the parameter of R and K is significantly decreased in aSAH.D-D and K are independent risk factors of DCI.Therefore

early monitoring of coagulation function can help predict the occurrence of DCI

as well as guide the therapies.

关键词

蛛网膜下腔出血迟发性脑缺血凝血象血栓弹力图

Keywords

subarachnoid hemorrhagedelayed cerebral ischemiacoagulationthromboelastography

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Department of Radiology,The First Affiliated Hospital of Chongqing Medical University

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