重症肝硬化诊断中应用血浆凝血因子和血小板各项参数检测的价值

The value of plasma coagulation factors and platelet parameters in the diagnosis of severe cirrhosis

目的探讨重症肝硬化诊断中应用血浆凝血因子和血小板各项参数检测的价值。方法选取2018年9月至2019年2月该院收治的重症肝硬化患者38例作为研究组,另选取同期该院体检的健康者38例作为对照组。分别对两组研究对象血浆凝血因子及血小板各项参数水平进行检测及比较。结果研究组血浆血小板计数、血小板压积水平明显低于对照组,血浆血小板平均分布宽度、平均血小板体积水平明显高于对照组,差异均有统计学意义(t=22.217、17.019、-16.855、33.226,P<0.05);研究组活化部分凝血活酶时间、凝血酶时间、凝血酶原时间均明显长于对照组,差异均有统计学意义(t=-30.381、-16.888、-11.697,P<0.05);研究组血浆纤维蛋白原及凝血因子Ⅱ、Ⅴ、Ⅶ、Ⅸ、Ⅹ水平均明显低于对照组,而凝血因子Ⅷ高于对照组,差异均有统计学意义(t=37.529、28.396、25.136、24.927、19.633、19.567、-21.131,P<0.05)。结论血浆凝血因子和血小板各项参数水平在重症肝硬化患者中变化明显,可作为重要检测指标用于重症肝病的辅助诊断中,及早发现患者凝血机制障碍,并有效评估患者肝脏受损程度,具有较高的临床诊断及指导治疗价值。

Objective To explore the value of plasma coagulation factors and platelet parameters in the diagnosis of severe cirrhosis.Methods A total of 38 patients with severe cirrhosis admitted to our hospital from September 2018 to February 2019 were selected as the study group,and 38 healthy people who underwent physical examination in our hospital during the same period were selected as the control group.The levels of plasma coagulation factors and platelet parameters were measured and compared between the two groups.Results The levels of platelet and platelet crit in the study group were significantly lower than those in the control group,while the levels of platelet distribution width and mean platelet volume in the study group were significantly higher than those in the control group(t=22.217,17.019,-16.855,-33.226,P<0.05).Activated partial thromboplastin time,thromnin time,prothrombin time in the study group were significantly longer than those in the control group(t=-30.381,-16.888,-11.697,P<0.05).The levels of plasma fibrinogen(FIB)and coagulation factorsⅡ,Ⅴ,Ⅶ,Ⅸ,Ⅹin the study group were significantly lower than those in the control group,while coagulation factorⅧ was higher than that in the control group(t=37.529,28.396,25.136,24.927,19.633,19.567,-21.131,P<0.05).Conclusion The levels of plasma coagulation factors and platelet parameters in patients with severe liver cirrhosis have significant changes,which can be used as an important detection index in the auxiliary diagnosis of severe liver disease.And obstacles of coagulation mechanism can be detected as early as possible,and the degree of liver damage can be effectively assessed by plasma coagulation factors and platelet parameters.It has higher clinical diagnostic and therapeutic value.