الملخص
【Objective】 To investigate the correlation and consistency between the parameters of thromboelastography(TEG) and routine coagulation tests, and to evaluate the application value of the two methods in heparin anticoagulation monitoring and coagulation function monitoring in patients receiving extracorporeal membrane oxygenation(ECMO) therapy. 【Methods】 A total of 138 patients who recieved ECMO in the Department of Critical Care Medicine of the People′s Hospital of Guangxi Zhuang Autonomous Region from October 2021 to December 2022 were selected. A total of 317 pairs of ordinary TEG and heparinase-modified TEG(hmTEG) parameters measured simultaneously were analyzed for correlation and consistency with activated partial thromboplastin time(APTT), fibrinogen(Fib), and platelet count(Plt), and the parameters tested when ECMO was established and 24 hours after ECMO operation were compared. 【Results】 The correlation coefficient between R values and APTT of hmTEG(r=0.441, P0.05), while as for hmTEG, the correlation was 0.359(P0.05). 【Conclusion】 The parameters of hmTEG can better reflect the real level of coagulation factors in patients receiving ECMO. The results of hmTEG and APTT are complementary to assess whether heparin in ECMO patients is overdosed, and hmTEG has unique advantages. Routine coagulation tests and TEG cannot replace each other, and the combination of them can achieve better anticoagulation and coagulation management.
الملخص
Objective To study and analyze the relation between cognitive impairment and apolipoprotein E(ApoE) gene polymorphism in post-stroke depression patients(PSD).Methods The patients were divided into PSD group(83 cases) and brain stroke group(96 cases) by using the 24-item Hamilton Depression Rating Scale (HAMD-24),and healthy volunteers were selected as a control group(53 cases).Cognitive function was evaluated by using the event-related potential (ERP) P300 and single nucleotide polymorphisms of ApoE exon 4 of 112 (rs429358) and 158 (rs7412) were determined by using gene sequencing method.Results 1.Compared with the brain stroke group and the control group,latency in ERP including N2 and P3 of PSD group was significantly prolonged (P＜ 0.05 ),while the amplitude of P3 in PSD was significantly lower(P＜ 0.05 ).2.e3/ε4 genotype frequency in PSD group(24 cases) was significantly higher than that in the control group(7 cases) (P＜0.05).The e4/4 genotype fiequency in PSD group (8 cases) was significantly higher than that in brain stroke group (2 cases) (P ＜ 0.05 ).The e4 allele rate in PSD group ( 24.7％ ) was significantly higher than that in both brain stroke group (16.1％) and contro] group(9.4％ ) (all P＜0.05).3.The PSD patients with ε4 allele had significantly higher score of HAMD-24 and prolonged latency of N2 and P3 than those without e4 allele (P ＜ 0.05 ).Conclusion There is cognitive impairment in PSD patients.The ApoE ε4 allele may associate with the cognitive impairment and depression in PSD patients.