凝血检测项目在冠心病患者中的结果分析

Analysis of Result of Coagulation System Indexes of Patients with Coronary Heart Disease

目的:观察冠心病患者凝血检测项目的变化,探讨D-二聚体、纤维蛋白原(Fib)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)在冠心病患者中的临床意义。方法:选择2014年1月至2015年12月在我院诊治的136例冠心病患者作为实验组,分为稳定型心绞痛(SA)组(39例)、不稳定型心绞痛(UA)组(60例)和急性心肌梗死(AMI)组(37例),同时选取我院同一时期的72例健康体检人员为对照组,采用STAGO全自动血凝仪检测PT、APTT、Fib,采用Sysmex CS5100自动凝血仪检测D-二聚体,收集各组人员首次检测时的D-二聚体、Fib、APTT、PT值,用SPSS20.0软件分析数据,计量资料数据以x±s表示,两两比较采用t检验,P<0.05表示有统计学差异。结果:对照组、UA组、SA组、AMI组的D-二聚体分别为0.3313±0.07746、1.3079±0.69572、1.0598±0.78955和1.3322±0.69385μg/m L,各实验组和对照组比较,均为P<0.05。对照组、UA组、SA组、AMI组的Fib分别为3.6250±0.85014、3.6872±1.08220、3.7967±0.94599和4.0486±1.54536 mg/d L,AMI组与对照组比较,P<0.05;SA组、UA组与对照组比较,P>0.05。对照组、UA组、SA组、AMI组的APTT分别为36.9208±7.89774、33.6256±5.70266、34.8117±6.69004和30.3081±6.61838 s,UA组、AMI组与对照组比较,P<0.05;SA组与对照组比较,P>0.05。对照组、UA组、SA组、AMI组的PT分别为13.8181±3.94088、13.2692±2.73266、13.7867±1.73806和13.4730±5.03525 s,各实验组和对照组比较,均为P>0.05。结论:与对照组比较,UA组、SA组、AMI组的D-二聚体均增高,且具有统计学意义,所以D-二聚体可以作为冠心病检测的敏感凝血系统指标;Fib、APTT、PT虽然对冠心病检测不是很敏感,但Fib有偏高趋势,而APTT、PT有偏低趋势,可以作为机体处于高凝血状态的监测指标,特别在AMI时,D-二聚体、Fib、APTT结果异常更明显。因此,检测这些凝血指标有助于冠心病的诊断和病情判断。

Objective：To investigate the clinical value on D-two dimer,fibrinogen（Fib）,activated partial thromboplastin time（APTT） and prothrombin time（PT） in patients with coronary heart. Methods：136 patients with coronary heart disease were selected in our hospital from January 2014 to December 2015 as the observation group.72 health physical examination personnel were selected in our hospital as the control group. The coronary heart disease group was further divided into acute myocardial infarction（AMI） group with 37 cases,unstable angina（UA） group with 110 cases and stable angina（SA） group with 39 cases. Comparisons were made on D-dimer,Fib,APTT,PT levels between observation groups and the control group. Results：D-two dimer in the observation group were significantly higher than those in the contral group and the differences were statistically significant（P〈0.05）. In the detection of Fib,AMI group was significantly higher than those in the contral group and the differences were statistically significant（P〈0.05）. The others were higher than those in the contral group,but the differences were not statistically significant（P〉0.05）. In the detection of APTT,AMI and UA group were significantly lower than those in the contral group and the differences were statistically significant（P〈0.05）. The others were lower than those in the contral group. PT in the observation group were significantly lower than those in the contral group,but the differences were not statistically significant（P〉0.05）. Conclusion：Patients with coronary heart disease have abnormal expression of D-dimer,so it can be a significant index in patients with coronary heart.APTT,PT,Fib were not very significant in patients with coronary heart,but the results of Fib were higher than those in the contral group,and the results of APTT,PT were lower than those in the contral group,so they can be the indexes in cogulation system for patients with coronary heart disease.