凝血指标和D-二聚体检测在肝病患者中的临床意义

Clinical significance of coagulation indexes and D-dimer detection in liver diseases

目的探讨凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)和D-二聚体(D-D)检测在判断肝病患者凝血功能状况、出血危险性及治疗预后方面的临床价值。方法采用Sysmex CA1500全自动血凝仪对136例肝病患者和97例健康体检者进行检测并作相关统计分析。结果与对照组比较,肝癌组和肝硬化组PT、APTT、TT均明显延长,FIB明显减少,D-D明显增加,差异有统计学意义(P<0.01)。普通肝炎组PT、APTT延长,差异有统计学意义(P<0.05);TT、FIB、D-D差异无统计学意义(P>0.05)。结论凝血指标和D-二聚体检测是区分不同肝病患者的比较敏感指标之一,而且对动态观察病情及预后具有一定的临床参考价值。

Objective To investigate the clinical value of prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（FIB） and D-dimer（DD） tests in determining the coagulation status,bleeding risk and prognosis of the patients with liver diseases.Methods The Sysmex CA1500 automated coagulometer was used for the detections on 136 patients with liver diseases and 97 healthy subjects and the related statistical analysis was performed.Results Compared with the healthy control group,PT,APTT and TT in liver cancer and cirrhosis groups were significantly prolonged,FIB was significantly reduced,DD significantly increased,the difference was statistically significant（P0.01）.PT and APTT in common hepatitis group were prolonged with statistical difference（P0.05）.The difference in TT,FIB,DD had no statistical significance（P0.05）.Conclusion The coagulation indexes and DD tests are the more sensitive indexes to distinguish various liver diseases and possess certain clinical reference value to dynamically observe the disease condition and judge prognosis.