慢性乙型肝炎后肝硬化的临床分期及与血小板和凝血功能的关系

Analysis of relationship between clinical stages of cirrhosis with platelet and blood coagulation function after chronic hepatitis B

目的了解慢性乙型肝炎(简称乙肝)后肝硬化的临床分期、疾病发展与血小板、凝血功能的关系和变化规律。方法回顾性分析2008～2010年123例慢性乙肝后肝硬化不同临床分期住院患者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)和血小板计数(PLT)的检测结果,并以健康体检者为对照进行统计学分析。结果慢性乙肝后肝硬化代偿组和失代偿组PT、APTT均较对照组显著延长,而Fib含量明显减低,PLT显著减少,差异也统计学意义(P<0.05);失代偿组较代偿组PT、APTT均显著延长,Fib及PLT则均低于代偿组,差异也有统计学意义(P<0.05)。结论凝血功能和PLT与肝硬化患者的疾病进展程度密切相关,对了解其肝功能损害程度、判断预后具有一定诊断和治疗意义。

Objective To understand the relationship between clinical stages and development of cirrhosis with platelet and blood coagulation function after chronic hepatitis B and its rule change. Methods With the retrospective analysis method,the detection results of PT, APTT, Fib and PLT in 123 inpatients with different clinical stages of cirrhosis after chronic hepatitis B were collected and compared with 31 healthy control for statistical analysis. Results PT and APTT in the groups of compensation and decompensation of cirrhosis after chronic hepatitis B were delayed greatly,Fib level and the quantity of PLT were decreased obviously, compared with normal control group. The difference between these groups was significant either compensation group or decompensation group of cirrhosis （P〈0.05）. PT and APTT in the group of decompensation of cirrhosis after chronic hepatitis B were delayed, Fib level and the quantity of PLT were decreased,compared with compensation group. The difference between the two groups was significant（P〈0.05）. Conclusion The blood coagulation function and platelet are closely related with the development of cirrhosis after chronic hepatitis B. Understanding the degree of functional lesion in liver has some diagnostic and therapeutic significance for judging the prognosis of cirrhosis.