联合检测凝血四项、D-二聚体、纤维蛋白原降解产物对肝病患者的临床价值分析

Clinical value of combined detection of four items of coagulation,D-dimer and fibrinogen degradation products in patients with liver disease

目的 研究肝病患者的凝血四项和D-二聚体(D-D)、纤维蛋白原降解产物(FDP)水平的变化情况以及其诊断价值。方法 选取40例肝病患者为观察组,同期本院体检健康者40例为对照组。两组均通过静脉采血检测并比较凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-D和FDP水平及阳性率。结果 观察组PT(17.16±1.66)s、APTT(41.26±4.29)s、TT(19.26±1.98)s长于对照组的(12.27±0.36)、(33.37±2.05)、(16.15±0.54)s,FIB(2.10±0.74)g/L低于对照组的(3.43±0.27)g/L,D-D(2.01±1.30)μg/ml、FDP(5.97±4.92)μg/ml高于对照组的(0.25±0.08)、(1.04±0.67)μg/ml,差异有统计学意义(P<0.05)。观察组患者的PT、APTT、FIB、TT、D-D和FDP阳性率均明显高于对照组,差异有统计学意义(P<0.05)。结论 凝血四项、D-D、FDP联合检测可评价肝病患者的凝血状态,根据FIB、D-D、FDP判断是否继发性纤溶亢进,为诊断、鉴别诊断、治疗提供重要证据,并帮助临床对肝病的动态观察及预后分析。

Objective To study the changes and value of combined detection of four items of coagulation,D-dimer(D-D) and fibrin/fibrinogen degradation products(FDP) in patients with liver disease.Methods 40 patients with various types of liver diseases were selected as the observation group,and 40 healthy subjects during the same period were selected as the control group.The prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-D and FDP levels and positive rates were detected by venous blood sampling in both groups.Prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT),D-D and FDP levels and positive rates were detected by venous blood sampling in both groups.Results In the observation group,the PT(17.16±1.66)s,APTT(41.26±4.29) s,and TT(19.26±1.98) s were longer than(12.27±0.36),(33.37±2.05),and(16.15±0.54) s in the control group;the FIB(2.10±0.74) g/L was lower than(3.43±0.27) g/L in the control group;the D-D(2.01±1.30) μg/ml and FDP(5.97±4.92) μg/ml were higher than(0.25±0.08) μg/ml and(1.04±0.67) μg/ml in the control group;all the differences were statistically significant(P<0.05).The positive rates of PT,APTT,FIB,TT,D-D and FDP in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion The combined detection of coagulation four items,D-D,and FDP can evaluate the coagulation status of patients with liver disease,and determine whether secondary hyperfibrinolysis is present according to FIB,D-D and FDP,thus providing important evidence for diagnosis,differential diagnosis and treatment,and helping dynamic observation and prognostic analysis of liver disease.