肝硬化出血患者血小板参数及凝血指标的检测价值研究

Detection Value of Platelet Parameters and Coagulation Indexes in Cirrhosis Patients with Hemorrhage

目的探究肝硬化出血患者血小板参数及凝血指标的检测价值。方法回顾性分析2016年1月-2017年1月入院的152例肝硬化出血患者(出血倾向组)、152例肝硬化无出血倾向患者(无出血倾向组)及152例同期体检健康者(体检健康组)临床病例资料。对比3组血小板参数[血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)]和凝血指标[凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、D-二聚体(DD)]的差异。结果 (1)肝硬化的2组患者PLT、PCT水平均低于体检健康组受试者(P<0.05),MPV、PDW水平均高于体检健康组受试者(P<0.05);且肝硬化2组中出血倾向组上述血小板参数指标变化幅度大于无出血倾向组(P<0.05);(2)肝硬化2组患者PT、TT、APTT、DD水平均高于体检健康组受试者(P<0.05),FIB水平则低于体检健康组受试者(P<0.05);且2组中,出血倾向组上述凝血指标变化幅度大于无出血倾向组(P<0.05);3组受试者AT-Ⅲ检测结果显示:体检健康组>出血倾向组>无出血倾向组(P<0.05)。结论血小板参数和相关凝血指标水平可反映肝硬化患者出血倾向,利于早期诊断和治疗,也可间接反映患者肝损害程度。

Objective To explore the detection value of platelet parameters and coagulation indexes in cirrhosis patients with hemorrhage.Methods The clinical data of 304 cirrhosis patients and 152 healthy persons from January 2016 to January 2017 were retrospectively analyzed.Among these people,152 cirrhosis patients with hemorrhage were divided into hemorrhagic tendency group,another 152 cirrhosis patients without hemorrhage were divided into non-hemorrhagic tendency group,and 152 healthy volunteers were divided into healthy group.The differences of platelet parameters[platelet count(PLT),plateletcrit(PCT),mean platelet volume(MPV)and platelet distribution width(PDW)]and coagulation indexes[prothrombin time(PT),thrombin time(TT),active part thrombin time(APTT),fibrinogen(FIB),antithrombin III(AT-III)and D-dimer(DD)]in the three groups were compared.Results The levels of PLT and PCT in the two cirrhosis groups were lower than those in the healthy group(P<0.05),the levels of MPV and PDW in the two cirrhosis groups were higher than those in the healthy group(P<0.05),and the change ranges of platelet parameters in the hemorrhagic tendency group were greater than those in the non-hemorrhagic tendency group(P<0.05),the levels of PT,TT,APTT and DD in the two cirrhosis groups were higher than those in the healthy group(P<0.05),the levels of FIB in the two cirrhosis groups were lower than those in the healthy group(P<0.05),and the change ranges of coagulation indexes in the hemorrhagic tendency group were greater than those in the nonhemorrhagic tendency group(P<0.05),the AT-III detection results showed that healthy group>hemorrhagic tendency group>non-hemorrhagic tendency group(P<0.05).Conclusion Platelet parameters and related coagulation indexes which are conducive to early diagnosis and treatment,can not only directly reflect the tendency of bleeding,but also indirectly reflect the degree of liver damage in patients with cirrhosis.