Clinical Application Of Thromboelastometry In Deep Vein Thrombosis Of Lower Extremity

Objectives To discuss the value of two coagulation function test methods in judging the coagulation status of DVT patients during treatment by analyzing the correlation and consistency between TEG and conventional coagulation assays of DVT patients undergoing treatment.In addition,by comparing the differences between TEG and conventional coagulation assays indicators in DVT patients and healthy volunteers,the value of related parameters of the two coagulation function test methods in predicting the occurrence of DVT was discussed.Methods A total of 87 patients with DVT who were admitted to the Interventional radiology Department of Hefei Hospital affiliated to Anhui Medical University from September 2017 to January 2021 and received anticoagulant,antiplatelet and thrombolytic therapy were enrolled in this retrospective study.Clinical data such as TEG and conventional coagulation assays indicators of each patient were collected.Spearman correlation analysis was used to analyze the correlation between the two coagulation function test methods,and Kappa consistency test was used to compare the consistency of the two coagulation function test results.In addition,21 newly admitted DVT patients with onset time of 4～48 hours and without any treatment in Interventional Radiology Department from July 2017 to June 2021 were included in the experimental group,while 41 healthy volunteers were included in the control group.±was used to measure TEG and conventional coagulation assays between the two groups.The student’s t test was used to compare the differences between the two groups.Median（interquartile range）was used for non-normally distributed measurement data,and Mann-Whitney U test was used to compare the differences between the two groups.The counting data were expressed as percentage（%）,and the?~2test was used for comparison between groups.Taking lower extremity DVT as the outcome variable,ROC curves of each indicator of traditional coagulation function test and TEG test were drawn,and AUC values for predicting the ability of lower extremity DVT were calculated to determine the cut-off point,sensitivity,specificity and Jorden index of each indicator.Results 1.The results of correlation and consistency analysis between TEG and conventional coagulation assays indexes of DVT patients during treatment:R and PT,R and APTT were positively correlated（r_s=0.231,0.395）;K was positively correlated with APTT（r_s=0.237）,and negatively correlated with FIB and PLT（r_s=-0.521,-0.431）;αwas positively correlated with FIB and PLT（r_s=0.542,0.471）;There was a positive correlation between MA and FIB,PLT（r_s=0.674,0.596）.The above differences were statistically significant（P<0.05）.The Kappa values of MA in TEG with PLT,FIB were 0.148,0.210,respectively（both P<0.05）,indicating that the MA of TEG is consistent with the conventional coagulation assays indexes PLT and FIB,but the consistency is poor.2.There were statistically significant differences in FIB,PT,APTT,D-dimer,R,K,αand CI between the two groups（P<0.05）.According to ROC curve,the AUC values of FIB,PT,APTT,D-dimer,R,K,αand CI were all greater than0.7,indicating that the above indicators have high predictive value for DVT.In general,the predictive value of TEG-related parameters such as R,αand CI was slightly higher than that of conventional coagulation assays indicators such as FIB,PT and APTT.Conclusion 1.For DVT patients,there is a significant correlation between TEG and conventional coagulation assays,but the consistency between the two methods is poor,and the two methods can’t replace each other.2.The R,K,α,CI of TEG and FIB,PT,APTT and D-dimer levels of conventional coagulation assays have certain diagnostic efficacy for DVT.The diagnostic efficacy of various indexes of TEG is slightly better than that of conventional coagulation assays indexes,which is worthy of popularization and application in clinic.