The Diagnostic Significance Of Thromboelastography And Conventional Coagulation Test In Liver Cirrhosis Complicated With Portal Vein Thrombosis

Objective: This article will study the clinical significance of thromboelastography(TEG)and conventional coagulation test(CCT)in liver cirrhosis and portal vein thrombosis(PVT),Discuss the correlation between TEG and CCT indicators and their diagnostic efficacy for liver cirrhosis and PVT and provide clinical evidence for the screening and prevention of liver cirrhosis and PVT.Provide clinical evidence for the screening and prevention of liver cirrhosis combined with PVT.Materials and methods: Selected 136 patients with liver cirrhosis who were diagnosed and treated in the Affiliated Hospital of Yan’an University from October 2016 to December 2020,and were divided into two groups according to their imaging examination results,namely combined PVT group and non-combined PVT group,and compared the two groups.General information(name,gender,age,height,weight,body mass index BMI,smoking history,drinking history),etiology data,liver function grade data,TEG data [reaction time(R),K-time(K),maximum amplitude(MA),Alpha angle(Angle),coagulation index(CI)] and CCT data [platelet count(PLT),prothrombin time(PT),plasma prothrombin activity(PT-%),prothrombin international normalized ratio(PT-INR),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time determination(TT),antithrombin Ⅲ(AT-Ⅲ),fibrin(original)degradation products(FDP),plasma D-dimer quantification(D-Dimer)],analyze the difference between the two groups.Using statistical methods,single-factor analysis of risk factors for PVT formation,and then a multi-factor analysis of independent risk factors for PVT formation;besides,the ROC curve was used to evaluate the diagnostic efficacy of meaningful indicators of single-factor analysis.Results: Comparing the general clinical data of the two groups of patients,there was no statistically significant difference in age,sex ratio,height,weight,smoking history,and drinking history(P>0.05);there was a statistically significant difference in BMI Significance(P<0.05),BMI of patients with PVT group was lower than that of patients without PVT group.Comparing the etiology data of the two groups of patients,there was no statistically significant difference in the etiology composition ratio(P>0.05).The liver function classification data of the two groups were compared,and there was no significant difference in the composition ratio of the liver function classification(P>0.05).Comparing the TEG data of the two groups of patients,the differences in the results of R,K,Angle,MA,and CI were statistically significant(P<0.05),patients in the combined PVT group have prolonged R,prolonged K,decreased Angle,decreased MA,and decreased CI.Comparing the CCT data of the two groups of patients,there was no statistically significant difference in PLT,PT,PT%,PT-INR,APTT,TT,AT-Ⅲ(P>0.05);the difference was statistically significant at the FIB level(P<0.01),the FIB level of patients in the PVT group was lower than that in the uncombined PVT group;the difference in FDP and D-Dimer levels was statistically significant(P<0.05),the patients in the PVT group The levels of FDP and D-Dimer were higher than those of the uncombined PVT group.In patients with liver cirrhosis,TEG and CCT have multiple indicators(PLT,PT,PT-%,PT-INR,APTT,FIB,TT,AT-Ⅲ)are associated(P<0.05),of which MA and PLT are present a strong positive correlation(r>0.5).The indicators with meaningful univariate analysis results were further analyzed by ROC curve,including FDP(AUC=0.637,Sen=86.8%,Spe=41.0%),D-Dimer(AUC=0.616,Sen=62.3%,Spe=63.9%),R(AUC=0.689,Sen=69.8%,Spe=74.7%),K(AUC=0.707,Sen=52.8%,Spe=86.7%)all have a certain diagnostic accuracy.The diagnostic accuracy of the combined index is higher than that of a single index(AUC=0.814),and it has better sensitivity and specificity(Sen=71.1%,Spe=84.3%).Conclusion: 1.Both thromboelastography and conventional coagulation tests can be used to measure the coagulation status of patients with liver cirrhosis.There is a wide correlation between the two groups of indicators.Clinicians should reasonably analyze the meaning of each indicator and comprehensively evaluate the coagulation level of patients.2.The combination of thromboelastogram and conventional coagulation test can more comprehensively monitor the coagulation status of patients with liver cirrhosis,R>5.58 min,K>4.85 min,FDP>2.40ug/ml,D-Dimer>1.45mg/L.At the same time,we should be more alert to the occurrence of PVT in patients with liver cirrhosis.