止凝血功能指标在乙肝、肝硬化及肝衰竭患者中的变化规律

The Changing Characteristic of Hemostasis and Coagulation Function Indexes in Patients with Hepatitis B,Cirrhosis and Liver Failure

目的探究止血和凝血功能指标在乙肝、肝硬化及肝衰竭患者中的变化规律。方法选取2015年8月至2016年8月于我院就诊的乙肝患者30例,肝硬化患者29例,肝衰竭患者28例,同期体检的30例健康人,分别为乙肝组、肝硬化组、肝衰竭组、正常对照组。分别检测所有患者的凝血酶原时间(PT)、活化部分凝血活酶时间(a PTT)、纤维蛋白原(Fbg)、蛋白C(PC:A)活性、纤溶降解产物(FDP)等止凝血功能指标。结果和正常对照组相比,乙肝组FDP显著升高(P<0.05),PT、aPTT、Fbg、PC:A无显著差异(P>0.05);和正常对照组、乙肝组相比,肝硬化和肝衰竭患者的PT和APTT显著延长(P<0.05),Fbg、PC:A显著下降(P<0.05),FDP显著升高(P<0.05);和肝硬化组相比,肝衰竭组PT、aPTT显著延长(P<0.05),Fbg显著降低(P<0.05),PC:A显著下降(P<0.05),FDP显著升高(P<0.05)。结论患者的止凝血障碍随着肝脏疾病的恶化而逐渐加重,检测PT、aPTT、Fbg、PC:A、FDP等止凝血功能指标对于了解患者肝脏病变程度及止凝血功能情况具有重要意义。

Objective To explore the changes of hemostasis and coagulation function in patients with hepatitis B ,liver cirrhosis and liver failure. Methods Choose 30 cases of hepatitis B patients, 29 cases of liver cirrhosis ,28 cases of liver failure and 30 cases of healthy persons in our hospital from August,2015 to August,2016. They were hepatitis B group, liver cirrhosis group, liver failure group, normal control group. prothrombin time （ PT ）, activated partial thromboplatin time （ aPTF ）, fibrinogen （ Fbg ）, PC： A, fibrinogen degradation products（FDP） were measured in all patients. Results Compared with the normal control group, the FDP of group B increased significantly （P 〈 0. 05 ） ;There were no significant differences of PT,aFFF,Fbg, PC：A（ P 〉 0. 05 ） ;Compared with normal control group and hepatitis B group, PT and aPTT were significantly prolonged in patients with cirrhosis and liver failure （ P 〈 0.05 ） , FIB, PC ： A were significantly decreased （P 〈 0.05 ） , FDP were significantly increased （ P 〈 0. 05 ） ; Compared with cirrhosis group, PT and aFFF of liver failure group were significantly prolonged （ P 〈 0. 05 ）, FIB were significantly decreased （ P 〈 0. 05 ）, PC ： A were significantly decreased （ P 〈 0. 05 ）, FDP were significantly increased （ P 〈 0. 05 ）. Conclusion The detection of PT, aFFF, Fbg, PC ： A, FDP and other indicators of anticoagulant function in order to understand the extent of liver disease and coagulation function of patients with important significance.