肝硬化患者血浆可溶性血栓调节蛋白和D-二聚体的检测及意义

Clinical significance of plasma soluble thrombomodulin and D-dimer detection in cirrhosis patients

[目的]探讨肝硬化患者血浆可溶性血栓调节蛋白(sTM)和D-二聚体的变化及其临床意义。\[方法]将82例肝硬化患者按肝功能Child-Pugh分级标准分为A、B、C 3组,再根据门静脉系统有无血栓形成分为血栓组、非血栓组;选择40例健康体检者作为对照(D)组;检测各组血浆的sTM和D-二聚体水平。[结果]肝硬化A、B、C组的sTM和D-二聚体水平显著高于D组(P<0.05),肝硬化血栓组的sTM和D-二聚体水平明显高于非血栓组(P<0.05),且随着肝功能Child-Pugh分级的恶化,sTM和D-二聚体水平明显升高。[结论]肝硬化患者存在不同程度的血管内皮细胞损伤及凝血和纤溶系统的激活,血浆sTM、D-二聚体水平可作为判断肝硬化病情严重程度、预测门静脉系统血栓形成的指标。

[Objective] To observe the change of plasma soluble thrombomodulin （sTM） and D-dimer in cirrhosis patients and evaluate their clinical significance. [Methods]Eighty-two cirrhosis patients were se- lected and divided into A, B and C groups according to Child-Pugh staging. They were also divided into portal vein thrombosis （PVT） group and non-PVT group. Forty cases of healthy individuals were enrolled as control group （D group）. Then plasma sTM and D-dimer were detected in those cirrhosis groups and controls. [Results]The levels of sTM and D-dimer in Child-Pugh A, B or C group were significantly higher than that in the control D group （P〈0.05）. Patients with PVT had higher sTM and D-dimer levels than non-PVT patients （P〈0.05）. The change was correlated with the severity of Child-Pugh. [Conclusion] Vascular endothelial cells are damaged and the coagulation and anticoagulation system is abnormal in cir- rhosis patients. The plasma sTM and D-dimer levels can be used as an important indicator of the severity and prognosis of PVT in cirrhosis patients.