慢性重型肝炎患者血浆D-二聚体和纤维蛋白原水平的变化

Plasma D-Dimer and Fibrin Changes in Chronic Severe Hepatitis Patients

目的:分析慢性重型肝炎患者血浆D-二聚体和纤维蛋白原水平的变化及其临床意义。方法:应用乳胶比浊法及凝固法分别测定血浆D-二聚体和纤维蛋白原的水平,其中慢性重型肝炎患者40例,慢性肝炎患者28例作为对照组。结果:慢性重型肝炎患者血浆D-二聚体及纤维蛋白原检测异常率分别为62.5%(25/40)、92.5%(37/40),明显高于慢性肝炎组0%(0/28)、28.6%(8/28)。慢性重型肝炎患者血浆D-二聚体及纤维蛋白原检测水平分别为3.45±1.90μg/mL、1.36±0.49 g/L,慢性肝炎组患者血浆D-二聚体及纤维蛋白原检测水平分别0.91±0.47μg/mL、2.53±1.02 g/L,组间比较差异有统计学意义。慢性重型肝炎组患者27例死亡,13例好转出院,死亡组患者血浆D-二聚体异常率74.1%(20/27),检测水平为3.92±1.76μg/mL,纤维蛋白原异常率100%(27/27),检测水平为1.17±0.4 g/L;好转组患者血浆D-二聚体异常率38.5%(5/13),检测水平为2.48±1.88μg/mL,纤维蛋白原异常率为76.9%(10/13),检测水平为1.74±0.44 g/L,差别有统计学意义。结论:慢性重型肝炎患者血浆D-二聚体水平明显增高,纤维蛋白原明显下降,并与患者的病情严重程度及预后相关,检测血浆D-二聚体和纤维蛋白原水平可以作为慢性重型肝炎患者病情轻重及预后判断的临床指标。

Objective： To analyze the change of plasma d-dimer and fibrinogen in chronic severe hepatitis patients and its clinical significance.Methods： The level of plasma d-dimer and fibrinogen are detected by latex turbidimetric method and coagulation.40 patients with chronic severe hepatitis and chronic hepatitis 28 cases as the control group.Results： The abnormal rates of plasma d-dimer and fibrinogen of chronic severe hepatitis patients are 62.5%（25/40）and 92.5%（37/40）,that are obviously higher than those chronic hepatitis patients.The inspection levels of plasma d-dimer and fibrinogen of chronic severe hepatitis patients are 3.45 ±1.90μg/mL and 1.36± 0.49g/L.The inspection levels of plasma d-dimer and fibrinogen of chronic hepatitis patients are 0.91 ±0.47μg/mL and 2.53±1.02g/L.There are significant differences between chronic severe hepatitis and chronic hepatitis patients.There are 27 patients death and 13 patients good recovery in chronic severe hepatitis patients.The abnormal rates and the inspection levels of plasma d-dimer and fibrinogen of death patients are 74.1%（20/27）,3.92±1.76 μg/mL,100%（27/27）and 1.17±0.4 g/L.The abnormal rates and the inspection levels of plasma d-dimer and fibrinogen of good recovery patients are 38.5%（5/13）,2.48±1.88 μg/mL,76.9%（10/13）and 1.74±0.44 g/L.There are significant differences between two groups.Conclusion： Chronic severe hepatitis patients have obviously higher levels of plasma d-dimer and lower levels of fibrinogen,that are related to the severity of the illness and prognosis.Detection the levels of plasma d-dimer and fibrinogen could be used as clinical routine markers to evaluate the severity of attacks and prognosis of chronic severe hepatitis patients.