肝病患者纤维蛋白溶解系统关键因子检测的意义

Significance in the Detection of Key Factors in Fibrinolytic System of Patients with Liver Diseases

目的研究肝病患者血浆中继发性纤维蛋白溶解系统中重要标志物D-二聚体（D-D）和纤维蛋白原（FIB）指标的变化及其临床意义.方法采用美国ACL-ELITEPRO全自动凝血仪检测35例健康体检者和94例不同肝病患者血浆中FIB和D-D含量.结果与健康体检正常组相比,各肝病组FIB含量降低,顺序为急性肝炎组〉健康对照组〉慢性肝炎组〉肝癌组〉肝硬化组.急性肝炎组和慢性肝炎组差别不显著,肝硬化组和肝癌组差别显著,差异有统计学意义（P〈0.05）;D-D含量升高顺序为健康对照组〈急性肝炎组〈慢性肝炎组〈肝癌组〈肝硬化组,各肝病组差异均有统计学意义.肝癌组和肝硬化组分别与急性肝炎组、慢性肝炎组和肝硬化组FIB和D-D含量比较均有显著差异,差异有统计学意义.结论血浆FIB和D-D可客观地反映肝病的严重程度.这为临床肝脏疾病的诊断、治疗以及判断预后提供了重要依据.

Objective To study the changes of important plasma indicators of secondary fibrinolytic system in patients with liver diseases , such as D-dimer （D-D） and fibrinogen （FIB）, and its clinical significance. Methods ACLs-ELITEPRO automatic coagulation instrument made in USA was used to detect the FIB and D-D contents in the plasma of 35 healthy subjects and 94 cases with liver diseases. Results Compared with that in the healthy normal group, the content of FIB in the liver disease group was lower. The declining order was as follows ： acute hepatitis group 〉 healthy controls 〉 chronic hepatitis liver cancer 〉 liver cirrhosis group, there was no significant difference in acute hepatitis group and chronic hepatitis group, and there were significant differences in cirrhosis group and HCC group （ P 〈 0.05 ） ; the order of increase in D-D level was as follows ： healthy control group 〈 the acute hepatitis group 〈 chronic hepatitis 〈 liver cancer group 〈 cirrhosis group,and the difference in each liver disease group was statistically significant. Compared with those in acute hepatitis, chronic hepatitis and cirrhosis groups, FIB and D-D contents in HCC and cirrhosis groups were significantly different. Conclusion FIB and D-D levels in plasma of patients with liver diseases can reflect objectively the severity of liver diseases. This may provide an important basis for the diagnosis, treatment and prognosis of liver diseases in clinic.