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肝硬化患者凝血四项、D-二聚体水平及AT-Ⅲ的表达及临床意义(1)
http://www.100md.com 2019年3月15日 《中国现代医生》 2019年第8期
     [摘要] 目的 探讨检测凝血四项、D-二聚体水平与抗凝血酶(AT-Ⅲ)对评价肝硬化患者疾病状况的价值。 方法 选择2016年2月~2018年7月我院收治的51例肝硬化患者为观察组,50例健康体检者为对照组,对两组研究对象的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体及AT-Ⅲ指标水平进行检测。 结果 观察组患者PT、APTT及TT均较对照组明显延长,FIB的含量较对照组低,差异具有统计学意义(P<0.05);在D-二聚体上观察组高于对照组,AT-Ⅲ上观察组低于对照组,差异有统计学意义(P<0.05);肝硬化患者随着病情的加重,PT、APTT、TT及D-二聚体呈逐渐上升趋势,而FIB、AT-Ⅲ呈逐渐下降趋势。 结论 针对肝硬化患者,对其凝血四项、D-二聚体及AT-Ⅲ指标水平进行检测,可以客观的评价患者的凝血状况,值得推广。

    [关键词] 肝硬化;凝血四项;D-二聚体;AT-Ⅲ

    [中图分类号] R575.2 [文献标识码] B [文章编号] 1673-9701(2019)08-0115-03

    [Abstract] Objective To investigate the value of detecting four items of blood coagulation, D-dimer and anti-thrombin (AT-III) in evaluating the disease status of patients with liver cirrhosis. Methods 51 patients with cirrhosis admitted in our hospital from February 2016 to July 2018 were included in the observation group, and 50 healthy subjects were selected as the control group. Prothrombin time(PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time(TT), D-dimer, and AT-Ⅲ of two groups were measured. Results The PT, APTT and TT of the observation group were significantly longer than those of the control group. The content of FIB in the observation group was lower than that of the control group, and the difference was statistically significant(P<0.05). The D-dimer of the observation group was higher than that of the control group. The AT-Ⅲ of the observation group was lower than that of the control group, and the difference was also statistically significant(P<0.05). The PT, APTT, TT and D-dimer showed a gradual increase with the aggravation of the disease in patients with liver cirrhosis, while FIB and AT-III showed a gradual decline. Conclusion For patients with cirrhosis, the detection of four items of coagulation, D-dimer and AT-III can objectively evaluate the coagulation status of patients and is worth promoting.

    [Key words] Cirrhosis; Four items of blood coagulation; D-dimer; AT-Ⅲ

    肝臟是人体中用于合成凝血酶原、凝血因子及抗凝血酶的重要器官,如果肝脏发生病变,会让机体在正常时维系的凝血及纤溶平衡被打破,进而引发不同程度的凝血异常及纤溶异常情况[1]。肝硬化是肝脏病变常见的类型,主要由各种病毒性肝炎进展而成,在疾病进展过程中,肝细胞破坏数量不断增加,逐渐使血管内皮受到损伤,使内外的凝血系统被激活[2-4]。肝硬化患者肝脏网状内皮系统的功能也受到损伤,削弱肝脏清除体内毒素、肠道细菌及活化凝血因子的能力,进一步导致凝血与抗凝机制发生紊乱,因此临床中提高肝硬化的检出非常关键。该文探讨了检测凝血四项、D-二聚体水平及AT-Ⅲ对于肝硬化评价的价值,现报道如下。

    1 资料与方法

    1.1 一般资料

    选取我院2016年2月~2018年7月接收的51例肝硬化病患者作为观察组,所有患者均符合全国病毒性肝炎及肝炎学术会议制定的《内科学》[5]中关于肝硬化的诊断标准,排除其他肝脏病变及精神疾病者。51例患者中男38例,女13例;年龄23~76岁,平均(48.6±2.4)岁。另外选取同期到我院接受健康体检的50例人员作为对照组,所选患者均无高血压病、冠心病、血栓疾病及脑梗死等疾病,其中男36例,女14例;年龄21~75岁,平均(47.9±2.5)岁。本研究经医院医学伦理会同意,研究对象也均签署知情同意书,对两组患者的一般资料进行分析,差异无统计学意义(P>0.05),具有可比性。, 百拇医药(王辉)
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