Objective: To investigate the correlation and consistency between thromboelastography (TEG) and routine tests, platelets count in different coagulation states (hypercoagulable, low coagulation, and normal coagulation) and to evaluate the clinical value of TEG, routine bloot test and Plt count.
Methods: The clinical data of 409 patients performed the TEG, coaglation 4 test and blood routine test in third Xiangya Hosptial of Central Sonth University from January 2015 to December 2017 were analyzed retrospectively. The TEG main parameters such as the activation time of clothing factor (R), the formation rate of blood clots (K), the maximal α-angle (Angle) and maximal amplitude (MA) were compared with prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), thrombin time (TT) in blood routine test as well as platelet (Plt) counts by using the person correlation, Kappa consistency and paired chi-square test in different coagulation states, at the same time the guiding rote of these 2 detection mathods for clinical application of blood was compared.
Results: R value positively correlated with PT, the correlation coefficient (r) under low, high and normal coagulation status was 0.376, 0.316 and 0.276 respectively (P<0.05); the Kruskal-Wallis test of pairwise comparison showed no statistical difference (P>0.05); the consistency of R with PT under low, high and normal coagalation status was 0.208, 0.227 and 0.131, respectively. The R value positively correlated with APTT, r value under low, high and normal coagulation status was 0.418, 0.258 and 0.458 respectively (P<0.05); the Kruskal Walls test of pairwise comparion showed that there was no difference between value of low and normal coagulation status (P>0.05), while there was difference between r value of low and high coagulation status (P<0.05), the consistences of R value with APTT under low, high and normal coagulatiom status was 0.338, 0.291 and 0.161, with statistical difference (P<0.05). K value negatively correlated with Fib, r value under low, high and mornal coagulation status was -0.611, -0.411 and 0.311 respectively (P<0.05); the Kruskal-Wallis test of pairwise comparison all showed that statistical difference (P<0.05); the consistencey of K value with Fib was 0.432, 0.481 and 0.323 respectively under low, high and normal coagulation states. K value negatively correlated with plt count, r value under low, high and normal coagulation status was -0.278, -0.238 and -0.278 respectively (P<0.05); the consistency of K value with Fib level under low,high and normal coagulation status was 0.401, 0.312 and 0.279 respectively(P<0.05). Angle postively correlated with Fib level, r value under low, high and normal coagulation status was 0.638, 0.538 and 0.438 respectively (P<0.05); the Kruskal-Wallis test of pairwise comparison showed the statistical difference (P<0.05); the consistency of Angle with under low,high and normal coagulation status Fib was 0.323, 0.357 and 0.288 respectively(P<0.05). MA value positively correlated with Fib level (r=0.351, 0.381 and 0.211, P<0.05); the Kruskal-Wallis test of pairwise comparison showed that there was no difference of r value under low- and high-coagulation states (P>0.05), while there were differences of r values under low- and high-coagulation states with normal coagulation (P<0.05); the consistency of MA with Fib level under 3 kinds of coagulation states was 0.510, 0.467 and 0.427 respectively (P<0.05). MA value positively correlated with Plt count (r=0.478, 0.515 and 0.378) respectively under 3 kinds of coagulation states; the Kruskal-Wallis test of pairuse comparison both showed the statistical difference (P<0.05); the consistency of MA with Plt count under 3 kinds of coagulation status was 0.581, 0.461 and 0.350 (P<0.05).
Conclusion: The TEG correlates with results of blood coagulation test and Plt detection; the correlation and consistecy of TEG with routine blood coagalation test and Plt detection are different under different status. Therefore, for patients who possibly had pathologic hyper- and hypo-coagulation, the TEG detection should be performed, so as to dynamically monitor the blood coagulation in vivo, guide the rational use of drugs and blood transfusion, reduce the risk of embolion and blood transfusion.