D-二聚体和肝纤维化Ⅰ类标志物在肝硬化患者血浆中的表达及其临床意义

The expression and clinical significance of D-dimer and Serum marks for liver fibrosis in patients with liver cirrhosis

目的 探讨血浆D-二聚体（D-dimer）和肝纤维化Ⅰ类标志物水平与肝硬化患者肝功能状况的关系.方法 检测198例研究对象（新诊断的肝硬化组80例、肝硬化治疗后组68例,对照组50例）血液中D-二聚体和肝纤维化Ⅰ类标志物水平.结果 与体检组和治疗后组比较,肝硬化组患者血浆D-二聚体和肝纤维化Ⅰ类标志物水平显著升高（P均＜0.05）,对照组与治疗后组比较,差异无统计学意义（P均＞0.05）,D-二聚体、肝纤维化Ⅰ类标志物水平与Child-Pugh肝功能分级密切相关.有腹水的肝硬化患者血浆D-二聚体和肝纤维化Ⅰ类标志物水高于无腹水的肝硬化患者;失代偿期的肝硬化患者血浆D-二聚体和肝纤维化Ⅰ类标志物水平显著高于代偿期的肝硬化患者;肝硬化患者血浆D-二聚体和肝纤维化Ⅰ类标志物水平与肝功能损害的严重程度呈正相关.结论 肝硬化患者血浆D-二聚体和肝纤维化Ⅰ类标志物的水平与肝硬化患者肝功能状况密切相关,是反映肝硬化患者肝功能状况的指标之一.

Objective To investgate the relationship between plasma D-dimer, serum marks （ LX, PIIIP, C-IV, HA） and liver function in patients with liver cirrhosis. Methods The levels of D-di- mer and serum marks for liver fibrosis were detected in 198 patients who were divided into cirrhosis group （group A）,healthy group （group B ） and standardized treatment group （group C ）. Results Compared with the healthy group or the standardized treatment group, the levels of D-dimer and serum marks in cir- rhosis group were significantly increased（ P 〈 0. 05 ）, but the differences were not significant between the healthy control group and the standardized treatment group（ P 〉 0.05 ）. And the levels of D-dimer and ser- um marks were closely correlated with Child-Pugh grading of liver function and ascites in patients with liv- er cirrhosis. The levels of D-dimer and serum marks for liver fibrosis were significantly higher in cirrhotic patients with ascites. Decompensated cirrhotic patients than those in cirrhotic patients without ascites and compensatory cirrhosis respectively. The levels of D-dimer and serum marks for liver fibrosis were positive- ly correlated with the severity of liver function damage. Conclusion The levels of D-dimer and serum marks are closely related to liver function in patients with liver cirrhosis. They are good indicators for eval- uating, liver function in these patients and have a better clinical application value.