慢性乙型病毒性肝炎患者血浆凝血因子活性水平与肝脏炎症分级及病理分期的关系

Relationship between levels of coagulation factors and classification of inflammation and pathological phases in patients with chronic hepatitis B

目的:探讨慢性乙型肝炎患者血浆凝血因子活性水平与肝脏炎症分级及病理分期的关系。方法:对83例经肝活检确诊的慢性乙型病毒性肝炎患者分别检测凝血酶原活动度(PA)、活化部分凝血活酶时间(APTT)、凝血因子Ⅱ、Ⅴ、Ⅶ、Ⅷ、Ⅸ、Ⅹ和vWF。结果:PA从炎症G2期到纤维化S2期明显低于对照组S0期(P<0.05);凝血因子Ⅱ、Ⅶ活性在炎症G3+4期均明显低于对照组G0期(P<0.05);因子Ⅷ活性水平从G1期开始均明显高于G0期(P<0.01),vWF活性水平从G2期开始明显高于G0期(P<0.05),因子Ⅱ活性水平从S2期到S4期明显低于对照组S0期(P<0.05),因子Ⅹ活性水平S4期明显低于对照组S0期(P<0.05);因子Ⅷ、vWF从S1期到S4期均明显高于对照组S0期(P<0.05)。结论:PT活动度及凝血因子Ⅱ、Ⅷ、Ⅹ和vWF活性在判断慢性肝脏炎症轻重以及纤维化程度方面有一定临床价值。

Objective：To investigate the relationship between levels of coagulation factors and classification of inflamma- tion and pathological phases in patients with chronic hepatitis B. Methods：Eighty-three patients with chronic hepatitis B proved by liver biopsy were examined. A series of coagulation tests including prothrombin activity （PA）, activated partial thromboplastin （APTT）. factor U, V, Ⅶ,Ⅷ,Ⅸ, X and vWF assay were performed. Results： The levels of prothrombin time activity in pa- tients with chronic hepatitis B were significantly lower from inflammation G2 and pathological S2 than in control group （P 〈 0.05） ; Factor 11 and Ⅶ were significantly lower in inflammation phase G3 ＋4 than control group（P 〈 0.05 ） ; Factor Ⅷ was significantly higher from inflammation phase Gito G, than control group（P 〈0.01 ） ; Factor vWF was significantly higher from in- flammation phase G2 to G4 than control group（P 〈0.05） ; Factor 11 was significantly lower from pathological S3 than in control group （P 〈 0.05） ; Factor X was significantly lower in pathological $4 than control group （P 〈 0.05 ） ; Factor Ⅷ and vWF were significantly higher from pathological S1 than control group （ P 〈 0.05 ） ; Conclusions ： The levels of prothrombin time activity, Factor Ⅱ, Ⅷ,X and vWF could reflect the severity of degree of inflammation and hepatic fibrosis in patients with chronic hepatic B.