乙型肝炎患者凝血功能与临床分型及血清HBV-DNA定量检测关系的研究

The study of the relationships between blood coagulation function and the clinical grading of hepatitis B as well as serum content of HBV-DNA

目的研究乙型肝炎(下称乙肝)患者凝血功能与乙肝临床分型及血清乙肝病毒核糖核酸(HBV-DNA)定量检测之间的关系。方法收集乙肝患者330例为研究组,收集健康人群50例作为健康对照组,分别检测凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(FIB)等凝血功能指标及血清HBV-DNA含量,比较临床分型各组的PT、APTT、FIB的关系和按血清的HBV-DNA定量分组的各组PT、APTT、FIB的关系。结果除了慢性乙肝(轻度)组的PT值与健康对照组差异无统计学意义外,其他各组乙肝患者的PT、APTT值都与健康对照组差异有统计学意义(P<0.05),特别是慢性乙肝(重度)和乙肝后肝硬化组与健康对照组、慢性乙肝(轻度)组相比3项值差异有统计学意义(P<0.01)。按血清HBV-DNA定量分组的各组患者的PT、APTT值与健康对照组相比差异有统计学意义(P<0.05),且DNA定量大于或等于103copy/mL的各组患者的APTT值都显著高于健康对照组(P<0.01)。结论慢性乙肝患者凝血功能异常程度随临床分型的加重而加重,但与病毒拷贝数的增加无正相关。APTT值的检测是反映乙肝患者凝血功能的灵敏指标。

Objective To study the relationships between blood coagulation function and the clinical grading of hepatitis B as well as serum content of HBV-DNA in patients with hepatitis B. Methods Three hundred and thirty cases of patients with hepatitis B and fifty healthy individuals （healthy control group） were enrolled in the study. The blood coagulation function indicators （prothrombin time, PT; activated partial thromboplastin time, APTT; fibrinogen,FIB） and the content of HBV-DNA in the sera of the patients with hepatitis B were measured. Then all blood coagulation function parameters were compared among the groups which were divided by the clinical grading and divided by the amount of HBV-DNA. Results PT and APTT value of the hepatitis B patients showed significant differences compared with controls （P〈0.05）, except PT of the mild chronic hepatitis B group. Especially, all parameters of coagulation function in the severe chronic hepatitis B group and the cirrhosis group were significantly different from those in the control group and the mild chronic hepatitis B group （P〈0.01）. PT and APTT of each disease group which was divided by HBV-DNA content was higher than that of the control group （P〈0.05） ,and APTT of the groups with a higher copies （more than 103 copies/ml） was significantly higher than that of the control group （P 〈0.01）. Conclusion With the aggravation of the clinical grading, the blood coagulation function of patients with chronic hepatitis B was exacerbated, but it was not positively correlated with the amount of HBV-DNA in the serum. APTT is a sensitive index for the blood coagulation function of patients with hepatitis B.