血浆D-二聚体在乙肝后肝硬化患者中的表达及与预后的关系

Expression of plasma D-dimer in patients with post-hepatitis B cirrhosis and its relationship with prognosis

目的探讨D-二聚体在乙肝后肝硬化患者外周血表达情况及其与预后的关系。方法选择105例乙肝后肝硬化患者进行研究,其中Child-Pugh A级23例,B级56例,C级26例,同时选取30例健康体检者作为对照组,比较Child-Pugh各分级患者血浆D二聚体水平与对照组的差异;根据有无腹水和随访期内生存情况,分别将105例乙肝后肝硬化患者分为有腹水组和无腹水组及死亡组和生存组,分析D-二聚体表达水平与病情及预后的关系。结果患者组中Child-Pugh A级、B级、C级患者血浆D-二聚体表达水平分别为(1.570±0.046)μg/L、(1.647±0.047)μg/L、(1.727±0.055)μg/L,明显高于对照组的(0.467±0.307)μg/L,差异均有统计学意义(P均<0.05);腹水组患者血浆D二聚体水平为(1.910±0.404)μg/L,无腹水组患者血浆D二聚体水平为(0.890±0.036)μg/L,腹水组显著高于无腹水组(P<0.05);死亡组患者血浆D-二聚体水平为(2.561±0.372)μg/L,生存组患者血浆D-二聚体水平为(1.697±0.548)μg/L,死亡组显著高于生存组(P<0.05)。结论血浆D-二聚体表达水平与乙肝后肝硬化患者疾病严重程度有关,并对预后有一定的指导价值。

Objective It is to investigate the expression of D-dimer in peripheral blood of patients with post-hepatitis B cirrhosis and its relationship with prognosis. Methods 105 patients with post-hepatitis B cirrhosis were selected, including 23 cases of Child-Pugh A, 56 cases of Child-Pugh B, and 26 cases of Child-Pugh C. At the same time, 30 healthy subjects were selected as the control group. The difference in plasma D-dimer level between the patients of every Child-Pugh classification and the control group were compared.105 cases of patients with post-hepatitis B cirrhosis were respectively divided into ascites group and non-ascites group, death group and survival group according to the presence or absence of ascites and survival during the follow-up period. The relationship between the level of dimer expression and the condition and prognosis was analyzed. Results The expression levels of plasma D-dimer in the patients with Child-Pugh Class A, B and C in the patient group were(1.570±0.046)μg/L,(1.647±0.047)μg/L,(1.727±0.055)μg/L, respectively, which were significantly higher than that of the control group(0.467±0.307)μg/L, the differences were statistically significant(P<0.05). The level of plasma D-dimer in the ascites group was(1.910±0.404)μg/L, in patients without ascites was(0.890±0.036)μg/L, the level was significantly higher in the ascites group than that in the non-ascites group(P<0.05). The plasma D-dimer level in the death group was(2.561±0.372) Ug/L, in the survival group was(1.697±0.548)μg/L, and the level in the death group was significantly higher than that in the survival group(P<0.05). Conclusion The expression level of plasma D-dimer is related to the severity of disease in patients with post-hepatitis B cirrhosis, and has a certain guiding value for prognosis.