Clinical Significance Of Thromboelastography In Patients With High Altitude Polycythemia

ObjectiveTo evaluate the consistency and correlation between thromboelastogram(TEG)and routine coagulation function in patients with high altitude polycythemia(HAPC).To analyze the clinical significance of thromboelastogram and platelet changes.MethodsThe Qinghai Provincial People’s Hospital was selected for elective cholecystectomy from March 2017 to July 2017.Preoperative blood routine examination of male hemoglobin was greater than 160g/L,and 78 patients with hyperhemoglobinemia with female hemoglobin greater than 150g/L received TEG,routine coagulation function index detection and platelet count(PLT)examination,correlation analysis of TEG parameters and coagulation parameters,PLT;according to the diagnostic criteria of HAPC developed by the 6th International Conference of Plateau Medicine and Hypoxic Physiology in 2004,78 subjects were divided into HAPC group and control group.The differences of TEG parameters,routine coagulation parameters and PLT were compared between the two groups.Results1.The hemagglutination block formation time(K)in TEG parameters of patients with hyperhemoglobinemia was positively correlated with partial thromboplastin time(APTT)and negative with plasma fibrinogen(FIB),D-dimer(DD)and PLT.Correlation;blood clot maximum intensity(MA)was negatively correlated with APTT,positively correlated with FIB and PLT;blood cell agglutination rate(Angle 角)was negatively correlated with APTT,positively correlated with FIB,DD,PLT;coagulation index(CI)It is negatively correlated with APTT and positively correlated with FIB,DD and PLT;among them,MA has the highest correlation with PLT and FIB(R=0.4009,0.4189).2.K in TEG parameters of patients with HAPC was negatively correlated with PLT.Angle 角,MA,CI was positively correlated with PLT.TEG parameters was no correlation with routine coagulation function index.3.The difference of TEG parameters and coagulation related indexes between HAPC group and control group showed that the difference between APTT,TT,PLT,K,MA and Cl groups was statistically significant(P<0.05),and HAPC group,APTTand TT were significant.Higher than the control group;MA,CI,PLT was significantly lower than the control group.Conclusion1.TEG has obvious correlation with coagulation function and PLT in the patients with hyperhemoglobinemia.2.There was a significant correlation between TEG and PLT in patients with HAPC,but no correlation with routine coagulation function indexes.TEG combined with routine coagulation function test can more comprehensively and accurately reflect the coagulation state in patients.3.With the gradual increase of hemoglobin concentration,the number and function of coagulation factor,FIB and platelet in HAPC patients decreased.