乙型肝炎患者凝血功能与血清HBV-DNA含量的相关性

Relationship between coagulative function and the content of HBV-DNA in patients with hepatitis B

目的研究乙型肝炎患者凝血功能与血清HBV—DNA含量之间的关系与意义。方法收集乙型肝炎患者486例，健康人群50例作为正常对照，分别检测其凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、纤维蛋白原（FIB）等三项凝血功能指标及血清HBV DNA含量。分析PT、APTT、FIB等指标在不同血清HBV—DNA含量组中的变化及意义。结果除HBV—DNA〈10^3copy／ml含量组的PT值与正常对照无差异外，其它各组PT值与正常对照组比较均有差异，特别是10^3copy／ml〈HBV—DNA〈10^7copy／ml时，与正常对照组比较具有具有显著性差异，乙型肝炎患者APTT值与正常对照组和乙肝患者HBV—DNA含量〈10^3copy／ml组比较均有显著性差异，特别是当HBV—DNA〉10^3copy／ml时，与正常对熙组比较差异具有显著性，不同HBV—DNA含量分组之间PT、APTT、FIB差异也有显著性。结论乙型肝炎病人凝血功能的异常随着病人体内HBV—DNA含量的增加有降低的趋势，特别是对于HBV—DNA含量在10^4～10^6copy／ml病人，应该随时监测病人的凝血功能，以防止出现严重的出血和把握抗病毒治疗的时机。

Objective To study the correlation between the coagulative function and the content of HBV-DNA in the serum of hepatitis B patients. Methods There were 486 patients with hepatitis B and 50 healthy individuals as control. Parameters of coagulative function （prothrombin time, activated partial thromboplastin time, fibrinogen） and the content of HBV-DNA in the serum of the patients with hepatitis B were measured. Then all parameters of coagulative function were analyzed among different groups divided by the content of HBV-DNA. Results The prothrombin time and activated partial thromboplastin time of each group were higher than those of control group （P〈 0.05）. There was significant difference in APTT and FIB between HBV-DNA〈103 hepatitis group and other groups. Conclusion With the increase of the content of HBV-DNA, the coagulative disfunction attenuates in patients with hepatitis B, but it is not positively correlated with the content of HBV-DNA in the serum. The coagulative function should be checked at any time in order to prevent serious bleeding disorders.