凝血因子检测对肝脏疾病的临床应用

Clinical application of coagulative factors on hepatic diseases

关键词:  肝脏疾病  凝血酶原时间  活化部分凝血酶原时间  纤维蛋白原  D-二聚体

Key words:  hepatitis  prothrombin time  partial thromboplastin time  fibrinogen  D-dimer

摘要:

探讨肝脏疾病对凝血机制和纤溶活化功能的影响，分析其与肝脏损害程度的关系。［方法］ 采用ACL-200型美国库尔特全自动血凝仪分别检测肝炎33例；肝硬化40例；肝癌28例；正常人40例，血凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和纤维蛋白原（FIB）；采用胶体金方法测定血浆D-二聚体。 ［结果］ 肝炎组的PT（ 13.6±1.06）s，APTT （32.4±4.57）s，FIB（ 2.57±0.46 ）g/L，D-二聚体（0.89±0.22 ）mg/L；肝硬化组PT （17.7±5.60）s，APTT （43.4±13.3）s，FIB （2.10±0.88 ）g/L，D-二聚体（2.46±0.61）mg/L; 肝癌组PT（15.05±2.74）s，APTT （36.8±5.55）s，FIB（3.50±1.16）g/L，D-二聚体（2.31±0.8） mg/L;它们与正常组PT （13.02±0.62）s；（APTT32.0±2.0 ）s； FIB （2.81±0.78） g/L；D-二聚体（0.45±0.11 ）mg/L比较有不同程度的差异 。［结论］不同病程肝脏疾病患者PT 、APTT、FIB、D-二聚体均可异常，其中肝硬化患者的各项指标变化最为显著。

Abstract:

To study the relationship between the coagulative factors of sera and different hepatic diseases. ［Methods］ Acl-200 automatic coagulometer was used to detect partial thromboplastin time test(APTT)、prothrombin time(PT)、fibrinogen(Fib) and the concentration of D-dimei．［Results］ The coagulation insufficiency and fibrinolytic activation existed in various degrees of all patients with different hepatic diseases. PT, APTT, FIB, D-dimer were respectively (13.6±1.06)s, (32.4±4.57)s, (2.57±0.46)g/L, (0.89±0.22) mg/L in patients with hepatitis, (17.7±5.60)s, (43.4±13.3)s, (2.10±0.88)g/L, (2.46±0.61)mg/L in patients with liver cirrhosis, (14.55±2.74)s,(34.8±5.55)s, (3.50±1.16)g/L, (2.31±0.8) mg/L in patients with liver cancer,(13.02±0.62)s, (32.0±2.0)s, (2.81±0.78)g/L,(0.45±0.11) mg/L in normal persons. There were significant differences among the groups of hepatitis, hepatocirrhosis , liver cancer and normal( P<0.05 or P<0.01). The values of D-dimer from hepatitis were not significantly different with those from normal subjects, (P>0.05); In contrast, increased levels of Fib (P<0.01) were detected in 28 liver cancer patients.［Conclusion］ A bnormal levels of PT, APTT, FIB and D-dimer were detected in patients with different hepatic diseases.