慢血、晚血、慢性乙型肝炎和肝硬化病人凝血、抗凝血及纤溶功能的研究

The study of coagulation,anti-coagulation and fibrinolysis function of chronic schistosomiasis,terminal schistosomiasis,chronic hepatitis B and liver cirrhosis patients

目的探讨慢血、晚血、慢性乙型肝炎和肝硬化患者的凝血、抗凝血及纤溶功能。方法收集血防站诊治的慢性、晚期血吸虫病和南昌大学第一附属医院住院的慢性乙型肝炎和肝硬化患者各50例及同期健康体检者50例作为对照组,测定和分析血浆凝血功能(PT、APTT、TT、Fg)、抗凝血功能(AT-Ⅲ、PC、PS)及纤溶功能[纤溶酶原(PLG)、D-二聚体(D-D)]。结果1、与健康对照组相比:⑴慢血组凝血功能(PT、APTT、TT、Fg)差异无显著性,抗凝血功能(AT-Ⅲ、PC、PS)差异有显著性,纤溶产物D-D水平差异有显著性而PLG无统计学差异;⑵晚血组PT、TT、Fg差异有显著性而APTT差异无显著性,抗凝血功能(AT-Ⅲ、PC、PS)和纤溶功能(PLG、D-D)差异有显著性;⑶慢性乙型肝炎和肝硬化组凝血功能、抗凝血和纤溶功能差异均有显著性;2、慢血组与晚血组比较:PT、TT差异有显著性而APTT、Fg差异无显著性,AT-Ⅲ、PC差异有显著性而PS差异无显著性,D-D、PLG差异有显著性;3、慢血组和慢性乙型肝炎组比较:凝血功能和抗凝血功能差异非常显著,纤溶功能PLG差异非常显著而D-D差异无显著性;4、晚血组和肝硬化组比较:凝血功能除TT差异无显著性外PT、APTT、Fg差异有显著性,抗凝血功能和纤溶功能差异有显著性;5、慢性乙型肝炎和肝硬化比较:TT、Fg差异无显著性而PT、APTT差异有显著性,抗凝血功能和D-D差异有显著性,PLG差异无显著性。结论慢血、晚血、慢性乙型肝炎及肝硬化患者均存在一定程度的凝血、抗凝血和纤溶功能紊乱,且凝血、抗凝血及纤溶指标的检测有助于监测慢血、晚血、慢性乙型肝炎及肝硬化患者病情的出凝血功能。

Objective To investigate coagulation,anti-coagulation and fibrinolysis function of chronic schistosomiasis,terminal schistosomiasis,chronic hepatitis B and liver cirrhosis patients. Methods The plasma samples of 50 chronic schistosomiasis and terminal schistosomiasis patients from antischistosomiaisis station ,50 chronic hepatitis B and liver cirrhosis patients from the first affiliated hospital of Nanchang university were collected and 50 healthy plasma as controls were also collected. The plasma coagu-lation function （PT,APTT,TT,Fg）,anti-coagulation function （AT-III、PC、PS） and fibrinolysis function （PLG） were tested and an-alyzed. Results 1.Compared with healthy controls： ⑴the chronic schistosomiasis group exhibit significant differences in the anti-coagulation function （AT-III、PC、PS） but no significant difference in the coagulation function （PT,APTT,TT and Fg）;the level of D-Dimer in chronic schistosomiasis group was significantly different,but the level of plasminogen was not significantly different.⑵the levels of PT,TT,Fg in the terminal schistosomiasis group were significantly different,but the level of APTT was not differ-ent;the terminal schistosomiasis group exhibit significant differences in the anti-coagulation and fibrinolysis function. ⑶The chronic hepatitis B and liver cirrhosis group exhibit significant differences in the coagulation ,anti-coagulation and fibrinolysis function. 2.There were significant differences in the level of PT,TT,AT-Ⅲ,PC,D-Dimer and plasminogen between the chronic schistosomiasis and terminal schistosomiasis group and no differences in the level of APTT ,Fg and PS. 3.There were significant differences in the coagulation,anti-coagulation function and the level of plasminogen between the chronic schistosomiasis and chronic hepatitis B group,and no difference was found in the level of D-Dimer. 4.There were significant differences in the coagula-tion（except the level of TT）,anti-coagulation and fibrinolysis function between the terminal schistosomiasis and liver cirrhosis group. 5.There were significant differences in the level of PT,APTT and D-Dimer and anti-coagulation function between the chronic hepatitis B and liver cirrhosis group,and there was no difference in the level of TT,Fg and plasminogen. Conclusion The chronic schistosomiasis,terminal schistosomiasis,chronic hepatitis B and liver cirrhosis patients present some disorders in coagula-tion,anti-coagulation and fibrinolysis function. The detection of coagulation,anti-coagulation and fibrinolysis indexes can help to monitor the haemostatic and coagulation function of the chronic schistosomiasis,terminal schistosomiasis,chronic hepatitis B and liver cirrhosis patients.