五项凝血指标在不同程度肝病患者中诊断结果的分析

Analysis of the Results of Five Coagulation Indexes in Patients With Different Degrees of Liver Disease

目的观察五项凝血指标在不同程度肝病患者中的结果。方法选取漳州市中医院2020年1月—2022年12月收治的肝病患者100例为肝病组,并选取同期于漳州市中医院健康体检未见异常的健康者30例为健康组。分析入组者的五项凝血指标[血浆凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,FIB)、凝血酶时间(thrombin time,TT)和国际标准化比值(international normalized ratio,INR)],明确不同类型肝病凝血指标水平;并将本组中的肝硬化患者根据肝功能Child-Push分级不同完成五项凝血指标检测,并加以比较。结果与健康组相比,肝硬化和肝炎患者PT、APTT、TT、INR指标更高,而FIB指标更低,差异有统计学意义(P<0.05)。与健康组比较,急性肝炎组PT、INR,轻度慢性肝炎组APTT、FIB,中度慢性肝炎组TT、APTT,重度慢性肝炎组PT、TT和INR差异均有统计学意义(P<0.05);轻度慢性肝炎组PT、TT、FIB和INR,中度和重度慢性肝炎组APTT水平与急性肝炎组比较,差异有统计学意义(P<0.05);中度、重度慢性肝炎组的PT、APTT、TT、FIB和INR水平与轻度肝炎组比较,差异有统计学意义(P<0.05);慢性轻度肝炎组PT、TT、FIB和INR,慢性中度和重度肝炎组APTT水平与急性肝炎组比较,差异有统计学意义(P<0.05);慢性中度和重度肝炎组PT、APTT、TT、FIB、INR水平与慢性轻度肝炎组比较,差异有统计学意义(P<0.05)。肝功能分级A级组与健康组之间的PT、TT、FIB水平差异均有统计学意义(P<0.05)。与健康对照组相比,C级组的PT、APTT、TT、FIB和INR水平差异均有统计学意义(P<0.05)。A级组与C级组间APTT、TT水平差异有统计学意义(P<0.05)。结论随着患者肝细胞受损程度不断加重,PT、APTT、TT逐渐延长,INR逐渐增加,而FIB水平则逐渐下降;五项凝血指标的检测结果,对评价肝脏受损程度、了解肝病不同病程凝血功能状况及预后等均具有重要意义。

Objective To observe and analyze the results of five coagulation indicators in patients with different degrees of liver disease.Methods A total of 100 patients with liver disease diagnosed in Zhangzhou Hospital of Traditional Chinese Medicine from January 2020 to December 2022 were selected as the liver disease group,and 30 healthy people who had no abnormal physical examination in our hospital during the same period were selected as the health group.Analyzed the five coagulation indexes[plasma prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT)and international standardized ratio(INR)]of the enrolled patients to determine the level of coagulation indexes in different types of liver diseases,and complete to detect and compare for five coagulation indexes according to the Child-Push classification of liver function in the patients with cirrhosis in this group.Results Compared with the healthy group,patients with liver cirrhosis and hepatitis had higher PT,APTT,TT,and INR indicators,while FIB indicators were lower,with statistically significant differences(P<0.05).Compared with the healthy group,there were statistically significant differences in PT,INR in the acute hepatitis group,APTT,FIB in the mild chronic hepatitis group,TT,APTT in the moderate chronic hepatitis group,and PT,TT,and INR in the severe chronic hepatitis group(P<0.05).The levels of PT,TT,FIB,and INR in the mild chronic hepatitis group,as well as APTT in the moderate and severe chronic hepatitis groups,were significantly different from those in the acute hepatitis group(P<0.05).The levels of PT,APTT,TT,FIB,and INR in the moderate and severe chronic hepatitis groups were significantly different from those in the mild hepatitis group(P<0.05).There were statistically significant differences in PT,TT,FIB levels between the A-level liver function grading group and the healthy group(P<0.05).Compared with the healthy control group,the differences in PT,APTT,TT,FIB,and INR levels in the C-level group were statistically significant(P<0.05).There was a statistically significant difference in APTT and TT levels between the A-level group and the C-level group(P<0.05).Conclusion With the aggravation of liver cell damage in patients,PT,APTT and TT are gradually prolonged,INR is gradually increased,and FIB level is gradually decreased.The detection results of five coagulation indicators are of great significance for evaluating the degree of liver damage,understanding the coagulation function status and prognosis of liver disease in different stages.