各项凝血指标在肝硬化患者诊治中的临床意义评估

Clinical value of coagulation index in liver cirrhosis diagnosis and treatment

目的:通过凝血实验室指标与临床病症的紧密结合,对肝硬化患者的诊断治疗和病情监测进行研究和分析。方法:对临床确诊的12例肝硬化代偿组(LC-1)、67例肝硬化失代偿组(LC-2)和健康对照组(N)进行PT、PA、APTT、FIB、V、VⅡ、VⅢ、DD及PLT的测定和分析。结果:1.肝硬化失代偿患者(LC-2)PT、PA、APTT、FIB、V、VⅡ、DD及PLT水平与N组比较均存在显著性差异(P<0.001);LC-2组与LC-1组比较,PT、PA、APTT、V、VⅡ、FIB水平存在显著性差异(P<0.01);2.肝硬化失代偿患者PA与VⅡ相关性最高(r=0.66);3.DD、V和VⅡ在肝硬化有腹水组和无腹水组之间均具有极显著性差异(P<0.001)。结论:1.DD、PT、PA、APTT、FIB、V、VⅡ、PLT水平对LC-2具有很好的诊断价值。2.PT、PA、APTT、V、VⅡ、FIB对LC-1与LC-2具有一定的鉴别价值。3.DD、V和VⅡ对肝硬化有腹水组和无腹水组具有一定的预测价值。4.DD、V、VⅡ和APTT对肝硬化的早期诊断、分期和预后具有重要的价值,应该加强其在临床的应用。

Objective： To study the clinical value of coagulation index in diagnosis,treatment and condition-observation in patients with liver cirrhosis.Methods：12 stable cirrhosis（LC-1）,67 advanced cirrhosis（LC-2） and 19 healthy persons（N）were collected.PT,PA,APTT,FIB,F,VⅡ,VⅢ,DD and PLT were detected.Results：1.The difference of DD,PT,PA,APTT,FIB,V,VⅡ,PLT in LC-2 compared with N group were all statistically significant.2.VⅡ correlated the best with PA in patientswith LC-2.3.The differences of DD,V,VⅡ between ascites and non-ascitesl were statistically significant.Conclusion：1.DD,PT,PA,APTT,FIB,V,VⅡ,PLT have a better diagnostic value for LC-2.2.PT,PA,APTT,V,VⅡ,FIB have some extent of differential value for LC-1 and LC-2 3.DD,V and VⅡ have some extentof predictable value for ascites 4.DD,V,VⅡ and APTT have important value for early-diagnosis and prognosis in liver cirrhosis.