肝病患者血浆D-二聚体和FDP含量水平分析

Content of plasma D-dimer and FDP in patients with liver disease

目的观察D-二聚体和纤维蛋白原降解产物(FDP)在严重程度不同肝病患者中的变化规律及应用价值。方法将30例健康体检者作为对照组,另外选取120例各类肝病患者,按不同病情分为4组,采用美国ACLTOP500型自动凝血分析仪检测D-二聚体和纤维蛋白原降解产物(FDP)含量水平。结果各种类型肝病患者的D-D和FDP水平均高于健康对照组(P<0.05);且在慢性乙型肝炎、肝硬化、肝衰竭、肝癌四种肝病中,慢性乙型肝炎组D-D和FDP水平最低,肝功能衰竭组D-D和FDP水平最高,差异均显著(P<0.05)。结论血浆D-二聚体和FDP含量水平在肝病患者病情发展的不同阶段有一定的变化规律,会表现出不同程度的增加,呈正相关性。可以通过二者的联合检测确定肝病患者的实时凝血功能,还可以根据二者动态变化情况,判断患者是否存在继发性纤溶和隐性弥散性血管内凝血(DIC),并为各类肝病的鉴别诊断、治疗及其预后评估和疾病转归提供依据。

Objective to observe the changes and application value of D-dimer and fibrinogen degradation products(FDP)in patients with different severity of liver disease. Methods Thirty healthy subjects were selected as the control group,and 120 patients with various liver diseases were selected.The patients were divided into 4 groups according to different conditions.The D-dimer and fibrinogen degradation products (FDP)were detected by American ACLTOP500 automatic coagulation analyzer.Results The levels of D-D and FDP in patients with various types of liver diseases were higher than those in healthy control group(P<0.05),and the levels of D-Dand FDP were the lowest in patients with chronic hepatitis B,cirrhosis,liver failure and liver cancer,and the highest in patients with liver failure(P<0.05).Conclusion the content of plasma D-dimer and FDP varies in different stages of liver disease,showing different degrees of increase,there is a positive correlation between them .We can help determine the real-time coagulation function of patients with liver diseases through the combined detection of the two,and can also determine whether patients have secondary fibrinolysis and recessive DIC according to the dynamic changes of the two,and provide important basis for the differential diagnosis, treatment,prognosis evaluation and disease prognosis of various liver diseases.