[1]姜丽,张娜,梅秀峰.慢性心力衰竭不同中医证型与血栓弹力图特征相关性研究[J].西部中医药,2025,38(01):60-66.[doi:10.12174/j.issn.2096-9600.2025.01.13]
　JIANG Li,ZHANG Na,MEI Xiufeng.Different TCM Syndromes of Chronic Heart Failure and the Characteristics of Thrombelastogram: A Correlational Study[J].Western Journal of Traditional Chinese Medicine,2025,38(01):60-66.[doi:10.12174/j.issn.2096-9600.2025.01.13]
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慢性心力衰竭不同中医证型与血栓弹力图特征相关性研究()
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
38
期数:
2025年01期
页码:
60-66
栏目:
调查分析
出版日期:
2025-01-15

文章信息/Info

Title:
Different TCM Syndromes of Chronic Heart Failure and the Characteristics of Thrombelastogram: A Correlational Study
作者:
姜丽, 张娜, 梅秀峰
淄博市中医医院，山东 淄博 255300
Author(s):
JIANG Li, ZHANG Na, MEI Xiufeng
Zibo Hospital of Traditional Chinese Medicine, Zibo255300, China
关键词:
慢性心力衰竭; 中医证型; 血栓弹力图; 相关性; 预后
Keywords:
chronic heart failure; TCM patterns; thrombelastogram; the correlation; prognosis
分类号:
R256.21
DOI:
10.12174/j.issn.2096-9600.2025.01.13
文献标志码:
B
摘要:
目的探究慢性心力衰竭（chronic heart failure，CHF）不同中医证型与血栓弹力图（thrombelastogram，TEG）特征的相关性。 方法比较152例不同证型CHF患者的一般资料和TEG特征；Pearson检验分析TEG特征与不同证型CHF的相关性；ROC曲线评价TEG特征对不同证型CHF患者预后的预测价值，并获得最佳临界值；根据最佳临界值将不同证型患者分别分为低危组、中危组和高危组，分别比较各组的不良预后发生率。 结果7种不同证型患者的左心室射血分数（left ventricular ejection fraction，LVEF）、高脂血症、糖尿病、心功能分级、红细胞分布宽度（red blood cell distribution width，RDW）、B型钠尿肽（B-type natriuretic peptide，BNP）、凝血反应时间、血凝块形成时间、Angle角、血栓最大振幅（maximum amplitude，MA）值、凝血综合指数（comprehensive index，CI）值比较差异均有统计学意义（P＜0.05）；凝血反应时间、血凝块形成时间分别与7种证型呈负相关（P＜0.05），Angle角、血栓MA值、凝血CI值分别与7种证型呈正相关（P＜0.05）；凝血反应时间预测7种证型（心肺气虚证、气阴两亏证、心肾阳虚证、气虚血瘀证、阳虚水泛证、痰饮阻肺证、阴竭阳脱证）患者预后的最佳临界值分别为6.54、6.12、5.63、5.78、6.08、5.45、5.37 min，血凝块形成时间的最佳临界值分别为2.46、2.37、2.10、2.02、2.32、1.95、1.87 min，Angle角的最佳临界值分别为64.32°、65.85°、70.12°、67.86°、66.12°、71.35°、73.24°，血栓MA值的最佳临界值分别为54.16、55.28、59.37、57.25、56.42、60.13、62.85 mm，凝血CI值的最佳临界值分别为0.95、1.06、1.47、1.22、1.18、1.54、1.62；7种证型高危组患者的不良预后发生率均高于中危组和低危组（P＜0.05）。 结论TEG特征指标凝血反应时间、血凝块形成时间、Angle角、血栓MA值、凝血CI值与CHF的不同中医证型均具有相关性，对患者的预后预测价值较高，有利于临床上早期识别不良预后的高危人群，积极采取有效的治疗措施。
Abstract:
ObjectiveTo investigate the correlation between different TCM syndromes of chronic heart failure (CHF) and the characteristics of thrombelastogram (TEG). MethodsThe general data and TEG characteris-tics of 152 CHF patients of different syndromes were compared; the connections between TEG characteristics and different patterns of CHF were analyzed using Pearson test; ROC curve was used to assess the prediction values of TEG characteristics on the prognosis of different patterns of CHF, and to obtain the optimal threshold; according to the optimal threshold, different patterns of the patients were respectively divided into low-risk group, moderate-risk group and high-risk group, to compare the incidences of adverse prognosis between different groups respec-tively. ResultsThe difference had statistical meaning in LVEF, hyperlipidemia, diabetes mellitus, cardiac function classification, RDW, BNP, blood coagulation reaction time (R time), clot formation time (K time), α angle, MA and CI between seven patterns of patients (P<0.05), R time and K time are negatively related to seven patterns respectively (P<0.05), α angle, MA and CI are positively correlated with seven syndromes separately (P<0.05); R time predicted that the optimal cut-off values of the prognosis of seven syndromes including heart-lung Qi deficiency pattern, both Qi and Yin depletion pattern, heart-kidney Yang deficiency pattern, Qi deficiency and blood stasis pattern, Yang deficiency and water flooding pattern, phlegm-fluid obstructing lung pattern, and Yin depletion and Yang loss pattern were 6.54, 6.12, 5.63, 5.78, 6.08, 5.45 and 5.37 min, the optimal thresholds of K time were 2.46, 2.37, 2.10, 2.02, 2.32, 1.95 and 1.87min, the best boundary values of α angle were 64.32°, 65.85°, 70.12°, 67.86°, 66.12°, 71.35° and 73.24°, the optimal thresholds of MA were 54.16, 55.28, 59.37, 57.25, 56.42, 60.13 and 62.85mm, the best critical values of CI were 0.95, 1.06, 1.47, 1.22, 1.18, 1.54 and 1.62; the incidence of adverse prognosis in seven syndromes of patients in high-risk group was higher than that of moderate-risk group and low-risk group (P<0.05). ConclusionCharacteristic indicators of TEG including R time, K time, α angle, MA and CI are related to different TCM patterns of CHF, with higher prediction values for the prognosis of the patients, which is conducive to early identification of adverse prognosis of high-risk population in clinic, and the positive adoption of the effective therapeutic measures.

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备注/Memo

备注/Memo:
姜丽（1983—），女，硕士学位，主治医师。研究方向：心血管相关疾病的中医诊治。山东省中医药科技发展计划项目（2017-356）。
更新日期/Last Update: 2025-01-15