人工肝治疗前后不同类型重症肝病凝血、抗凝、纤溶功能变化

Coagulation, anticoagulation and fibrinolysis function in patients with severe hepatopathy before and after artificial liver treatment

目的:探讨重症肝病患者人工肝支持系统(ALSS)治疗前后凝血、抗凝、纤溶功能的变化。方法:PT、APTT、TT、Fib检测采用凝固法,AT-Ⅲ、PLG检测采用发色底物法,D-D检测采用免疫浊法,ALT和AST检测采用速率法;分别应用STA型全自动血凝分析仪及其相配套的试剂和Olympus800全自动生化分析仪检测。结果:凝血指标PT、APTT、TT在ALSS治疗后分别缩短了(11.8±13.0)s、(65.5±57.5)s、(20.7±62.7)s(P均<0.01);Fib治疗后增加了(1.03±0.60)g/L(P<0.01);D-二聚体和PLG分别减少了(1.09±2.2)μg/ml、(28.8±21.7)μg/ml(P均<0.01);AT-Ⅲ活性增加了(29.6±42.5)%(P<0.01);ALT和AST分别降低了(49.4±58.7)U和(51.6±72.8)U(P均<0.01)。结论:ALSS能够改善重症肝病患者的凝血、抗凝、纤溶功能。

Objective： To observe the efficiency of artificial liver support system on coagulation-anticoagulation-fibrinolysis function in patients with severe hepatopathy. Methods： Coagulation, anticoagulation, fibrinolysis and liver functions were assessed by comparing PT,APTT,TT,Fib,D-D ,AT-Ⅲ ,PLG,ALT and AST in 32 patients before and after artificial liver support system treatment. Results：PT,APTT and TT were shortened and D-D, ALT and AST decreased （P 〈 0.01 ）, and Fib, AT-Ⅲ and PLG increased （P 〈 0.01 ） after artificial liver support system treatment. Conclusion： The artificial liver support system is very significant to evaluate coagulation-anticoaguahion-fibrinolysis function in patients with severe hepatitis, specially in early and middle stage.