凝血功能在评估肝脏疾病中的临床意义

Clinical significance of coagulation function on the evaluation of liver disease

目的探讨凝血功能在评估肝脏疾病中的临床意义。方法回顾性选取2019年1月至2020年1月首都医科大学附属北京世纪坛医院收治的肝病患者的临床资料,其中,肝囊肿患者41例,肝硬化患者148例,肝癌患者108例,另取健康体检者97名。检测所有对象的凝血功能,包括凝血酶原时间(PT)、凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)水平;检测肝硬化组和肝癌组的D-二聚体,对FIB和D-二聚体进行相关性分析。结果肝囊肿组PT、APTT、TT和FIB与对照组相比,差异均无统计学意义(P>0.05);与对照组相比,肝硬化组PT、APTT、TT分别为(17.02±7.46)、(36.37±5.81)、(17.42±3.25)s,均明显延长,FIB为(2.07±0.57)g/L,显著降低,差异均有统计学意义(P<0.05);与对照组相比,肝癌组PT、APTT、TT分别为(14.18±3.25)、(33.69±6.08)、(15.88±1.91)s,均延长,差异均有统计学意义(P<0.05),而FIB为(2.66±0.97)g/L,差异无统计学意义(P>0.05)。肝囊肿组PTA为(98.10±8.13)%,与对照组相比[(93.30±7.56)%],差异无统计学意义(P>0.05);肝硬化组、肝癌组PTA分别为(58.49±15.10)%、(72.19±16.64)%,均较对照组显著降低,差异均有统计学意义(P<0.05)。肝硬化组D-二聚体与FIB无明显相关(r=-0.051,P>0.05);肝癌组D-二聚体与FIB呈负相关(r=-0.257,P<0.05)。结论通过检测凝血功能,可评估不同肝脏疾病时肝细胞的损伤程度,为肝病患者的临床诊治和疾病预判提供理论依据。

Objective To investigate the clinical significance of coagulation function in patients with liver diseases.Methods The patients with different liver disease who had been diagnosed in Beijing Shijitan Hospital,Capital Medical University from January 2019 to January2020 were retrospectively selected,including 41 liver cyst patients,148 cirrhosis patients,108 liver cancer patients,and another 97 healthy examinees were selected.The value of four blood coagulation tests,prothrombin time( PT),prothrombin activity( PTA),activated partial thromboplastin time( APTT),thrombin time( TT),fibrinogen( FIB) were analyzed on all the people,D-dimer was tested on cirrhosis patients and liver cancer patients.Results There was no significant difference in PT,APTT,TT and FIB between the liver cyst group and the control group( P >0.05);The PT,APTT,and TT in the cirrhosis group were( 17.02 ± 7.46) s,( 36.37 ± 5.81) s,and( 17.42 ± 3.25) s,which were significantly longer than those in the control group,and the FIB was( 2.07 ± 0.57) g/L,which was significantly lower than that in the control group,and the differences were statistically significant( P < 0.05);The PT,APTT,and TT in the liver cancer group were( 14.18 ± 3.25) s,( 33.69± 6.08) s,and( 15.88 ± 1.91) s,which were longer than those in the control group,and the differences were statistically significant( P <0.05),while the FIB was( 2.66 ± 0.97) g/L,compared with the control group,the difference was not statistically significant( P > 0.05).The PTA of the liver cyst group was( 98.10 ± 8.13) %,compared with the control group [( 93.30 ± 7.56) % ],the difference was not statistically significant( P > 0.05);the PTA of the liver cirrhosis group and the liver cancer group was( 58.49 ± 15.10) % and( 72.19 ± 16.64) %,which were significantly lower than those in the control group,and the differences were statistically significant( P < 0.05).There was no significant correlation between D-dimer and FIB in liver cirrhosis group( r =-0.051,P > 0.05);D-dimer in liver cancer group was negatively correlated with FIB( r =-0.257,P < 0.05).Conclusion By detecting the coagulation function with different liver disease,the degree of liver cell damage can be assessed,which can provide theoretical basis for clinical treatment and disease prediction.