结核病患者凝血检查变化的临床意义

Clinical significance of the changes of coagulant examination in patients with tuberculosis

目的探讨结核病患者凝血检查变化的临床意义。方法 508例明确诊断为结核病且"活动性结核病变"患者作为结核病组,其中330例肺结核或继发性肺结核患者作为A组,72例结核性胸膜炎患者作为B组,64例结核性腹膜炎患者作为C组,42例结核性脑膜炎患者作为D组。另取同期214例健康者作为健康对照组。两组均进行血清凝血检查。比较两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fbg)和凝血酶时间(TT)及血小板计数(PLT)。结果结核病组与健康对照组血清PT、APTT、Fbg、PLT水平比较,差异有统计学意义(P<0.05);结核病组中A组TT为(27.58±7.16)s、B组为(27.19±3.11)s、C组为(26.43±4.57)s、D组为(28.43±3.77)s,明显长于健康对照组的(11.43±1.61)s,差异有统计学意义(P<0.05)。B组血清PT、Fbg水平、C组血清TT、PLT水平及D组血清APTT水平与其他不同分型组内比较,差异均有统计学意义(P<0.05)。结论结核病患者与健康人血清中存在特异性凝血指标,且不同分型间存在显著差异,但是否与治疗效果相关还需要进一步探讨。

Objective To investigate the significance of changes of coagulant examination in patients with tuberculosis. Methods A total of 508 patients who diagnosed as tuberculosis and active tuberculosis were selected as tuberculosis group, among them, 330 patients with pulmonary tuberculosis or secondary pulmonary tuberculosis were regarded as group A, 72 patients with tuberculous pleurisy were regarded as group B, 64 patients with tuberculous peritonitis were regarded as group C, and 42 patients with tuberculous meningitis were regarded as group D. Another 214 healthy persons in the same period were selected as healthy control group. Blood coagulation tests were performed in the two groups. The prothrombin time（PT）, activated partial thromboplastin time（APTT）, fibrinogen（Fbg）, thrombin time（TT） and platelet count（PLT） between the two groups were compared. Results The serum levels of PT, APTT, Fbg and PLT in the tuberculosis group and healthy control group, the differences were statistically significant（P〈0.05）. The TT level of group A, group B, group C and group D in tuberculosis group were（27.58±7.16） s,（27.19±3.11） s,（26.43±4.57） s and（28.43±3.77） s respectively, which were significantly longer than（11.43±1.61） s in the healthy control group, the differences were statistically significant（P〈0.05）. The levels of serum PT and Fbg of the group B, levels of serum TT, PLT of the group C and serum APTT level of group D were compared within different types of other groups, the differences were statistically significant（P〈0.05）. Conclusion Specific coagulation markers exist in the serum of tuberculosis patients and healthy people, and there are significant differences between different types, but whether it is related to the treatment effect needs further discussion.