重症肝病患者凝血指标和血小板参数检测的临床价值

Critically ill liver disease patient hemoglutination target and blood platelet parameter examination clinical value

目的探讨重症肝病患者凝血指标和血小板参数变化与病情的关系。方法分别应用SysmexCA-50半自动血凝仪和SysmexXS800i全自动五分类血细胞分析仪检测120例重症肝病患者和50例健康对照者及30例非重型肝炎组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白(Fbg)和血小板计数(PLT)、血小板压积(PCT)、血小板分布宽度(PDW)、血小板平均体积(MPV)。结果非重型肝炎组与健康对照组比较,只有PLT、PCT低于健康对照组(P<0.05),其他6项差异无统计学意义;急、慢性重型肝炎组、肝硬化组、肝癌组与健康对照组比较,PT、APTT、TT明显延长,与肝细胞的受损程度呈正相关,Fbg、PLT、PCT显著减少,与肝细胞的受损程度呈负相关,MPV增大。结论重症肝病患者血液处于明显低凝状态,具有出血倾向。对重症肝病患者进行有关治疗前联合检测凝血指标和血小板参数,有助于早期发现肝病患者的凝血机制障碍,对其及早预防继发性出血和抢救及预后治疗有重要的临床意义。

Objective Discussion critically ill liver disease patient hemoglutination target and blood platelet parameter variation and condition relations.Methods Congeals separately using the SysmexCA-50 semiautomatic blood the meter and Sysmex XS the 800i completely automatic five classification blood corpuscle analyzer examines 120 example critically ill liver disease patient and 50 example healthy collators and 30 example non-heavy hepatitis group zymoplasm original time（PT）,activation partial thrombokinase time（APTT）,zymoplasm time（TT）,fibrin（Fbg）and platelet count（PLT）,the blood platelet pressure accumulates（PCT）,blood platelet distribution width（PDW）,blood platelet average volume（MPV）.Results Non-heavy hepatitis group compares with the healthy control group,only then PLT,PCT are lower than the healthy control group（P〈0.05）,other 6 difference non-statistics significance;Anxious,the chronic heavy hepatitis group,liver cirrhosis group,liver cancer group compare with the healthy control group,PT,APTT,the TT obvious extension,suffers injury the degree present with the liver cell to be related,Fbg,PLT,the PCT remarkable reduction,suffers injury the degree with the liver cell to assume the inverse correlation,MPV increases.Conclusion Critically ill liver disease patient blood is at obviously congeals lowly the condition,has the hemorrhage tendency.Carries on the related treatment before the critically ill liver disease patient to unite the examination hemoglutination target and the blood platelet parameter,is helpful in the early discovery liver disease patient＇s hemoglutination machine-made barrier,prevents the sequential hemorrhage and the rescue and the prognosis treatment early to it has the vital clinical significance.