Thrombelastogram In Application Value In The Analysis Of Diagnosis And Treatment Of Patients With Unstable Angina

Objective:Through prospective analysis of coronary angiography and thrombelastography results of the patients who underwent coronary angiography in our hospital,an analysis was made whether the blood coagulation function detected by thrombelastogramin was associated with the severity of coronary heart disease among patients with coronary artery disease,and an evaluation of the effect of coagulation function on adverse events of patients with coronary heart after PCI within one year.Methods:From March 21,2016 to December 30.2016,88 cases that underwent coronary angiography were continuously selected in our hospital.The R value,K value,alpha angle,and MA value of thrombelastography were measured,and per the results of coronary angiography images,the Gensini scores of the lesion parts were estimated by two qualified and experienced doctors,and at the same time,the number of the lesioned blood vessels was also estimated.If the number of lesioned major coronary vessels is two or more than two,or the major branch stenosis diameter is more than fifty percent,then it is defined as multivessel disease(MVD).If it does not meet the criteria above,it is considered non multivessel disease(NMVD).Combining the two kinds of results,the severity of patients with coronary artery disease was evaluated,and analyzed by the T test and the analysis of correlation.The general parameters of thrombelastography of the multivessel disease and the non-multivessel disease,general blood biochemical results and the myocardial markers,etc.in the low&middle&high risk group in Gensini score were compared.The patients among the 88 cases above who underwent PCI were selected;both the event time and number of occurrences were recorded statistically.The patients were divided into a high MA group(MA>= 65mm),and a low MA group(MA<65mm)according to the MA values measured via thrombelastogram.The effect of the MA value on the prognosis of the patients after PCl in the two groups by chi square test were analyzed.The main adverse cardiovascular and cerebrovascular events(MACCE)include all-cause death after PCI,non-fatal recurrent myocardial infarction,new onset stroke,severe bleeding,unplanned revascularization.and readmission for heart failure.Results:(1)According to coronary angiography Gensini scores.49 patients were divided into the GSlow group(<41 scores).30 patients into the GSmid group(41?GSmid<64),9 patients into high-risk group(?64scores).There was no significant difference among the clinical types of the patients in the three groups,and no significant difference among the baseline level.The results of analyzing the conventional indexes of blood biochemical results,myocardial biochemical indexes,coagulation,etc.,of patients in two groups,and TEG parameters were as follows:the maximum amplitude(MA),clotting time(R value),fibrinogen time(K value),the alpha angle,platelet thrombocytocrit(PCT),platelet count(PLT),fibrinogen(Fib),thrombin time(TT)in the two groups had significant differences.The indexes above were related to the lesion severity of the coronary arteries.Made the logistic regression analysis among the index mentioned above,Find MA value associated with the severity of coronary artery lesions(2).According to the number of lesioned vessels,the patients were divided into multivessel disease group and non-multivessel disease group:The maximum blood clot strength(MA)and lesioned vessel count line correlation analysis,MA value,the greater the possibility of patients with multiple lesions(3).Analyzed by the chi square test,MA value was related with the prognosis of the patients after PCI(MACCE).When the MA value is greater than or equal to 65mm,possibility of MACCE increases.Conclusion:(1)The MA,R value,K value,alpha angle calculated by detecting the coagulation function of the patients with coronary heart disease via thrombelastograghy and thrombocytocrit(PCT),fibrinogen(FIB)in general blood biochemical indexes have a certain correlation with the severity of coronary artery disease.MA,the greater the value the higher the Gensini score(2)The MA value is correlated with the prognosis of the patients after PCI.A hypercoagulable state will influence the incidence of MACCE.