凝血四项指标检测对肝硬化患者的临床价值

Clinical value of coagulation four items testing in patients with cirrhosis

目的研究凝血四项指标检验对肝硬化患者的临床价值。方法选择2020年3月—2022年3月泗洪分金亭医院收治的77例肝硬化患者作为肝硬化组,根据患者的肝性脑病程度、腹水程度、胆红素和白蛋白水平、凝血酶原时间(PT)等进行Child-Pugh评分,根据评分标准分为A级(28例)、B级(34例)以及C级(15例);另外选择同期60例健康体检者作为对照组。入组者均采集空腹静脉血,以凝固法采用血凝仪检测血浆中活化部分凝血活酶时间(APTT)、PT、凝血酶时间(TT)及纤维蛋白原(FIB);比较对照组与肝硬化组以及不同Child-Pugh肝功能分级亚组的APTT、FIB、PT及TT水平。结果肝硬化组的APTT、PT及TT水平均明显高于对照组,FIB水平明显低于对照组[APTT(s):49.72±10.59比25.33±8.49,PT(s):18.36±2.49比11.15±2.65,TT(s):20.88±3.16比14.52±1.29,FIB(g/L):1.39±0.27比2.77±0.56,均P<0.05]。与Child-Pugh A级组、Child-Pugh B级组比较,Child-Pugh C级组APTT、PT及TT水平均更高,FIB水平更低[APTT(s):63.56±17.85比32.55±3.26、40.77±6.95,PT(s):24.39±7.66比12.44±0.79、14.89±1.59,TT(s):25.89±7.69比19.26±1.26、21.54±4.58,FIB(g/L):1.21±0.12比2.04±0.55、1.77±0.26,均P<0.05];与Child-PughA级组比较,Child-PughB级组的APTT、PT及TT水平均更高,FIB水平更低(均P<0.05)。结论肝硬化患者检验凝血四项指标可为疾病诊断提供可靠依据,并准确判断病情严重程度。

Objective To investigate the clinical value of coagulation four items testing in patients with cirrhosis.Methods A total of 77 patients diagnosed with cirrhosis admitted to Sihong Fenjinting Hospital from March 2020 to March 2022 were selected as cirrhosis group.Child-Pugh scores were assigned based on the degree of hepatic encephalopathy,ascites severity,bilirubin and albumin levels and prothrombin time(PT).The patients were classified into A grade(28 cases),B grade(34 cases)and C grade(15 cases)according to the scoring criteria.Additionally,60 healthy individuals undergoing physical examination during the same period were selected as control group.Fasting venous blood samples were collected from all participants,and using the coagulation method with an coagulometer,the levels of activated partial thromboplastin time(APTT),PT,thrombin time(TT)and fibrinogen(FIB)in plasma were determined.A comparison of APTT,FIB,PT and TT levels was made between the control and cirrhosis groups and among different Child-Pugh liver function grade subgroups.Results The cirrhosis group exhibited significantly elevated levels of APTT,PT and TT compared to the control group,while the level of FIB was markedly lower in cirrhosis group[APTT(s):49.72±10.59 vs.25.33±8.49,PT(s):18.36±2.49 vs.11.15±2.65,TT(s):20.88±3.16 vs.14.52±1.29,FIB(g/L):1.39±0.27 vs.2.77±0.56,all P<0.05].When comparing Child-Pugh A,B and C grade subgroups,the Child C grade subgroup showed higher APTT,PT and TT levels and lower FIB level than Child-Pugh A and B grade subgroups[APTT(s):63.56±17.85 vs.32.55±3.26,40.77±6.95,PT(s):24.39±7.66 vs.12.44±0.79,14.89±1.59,TT(s):25.89±7.69 vs.19.26±1.26,21.54±4.58,FIB(g/L):1.21±0.12 vs.2.04±0.55,1.77±0.26,all P<0.05].When compared to the Child-Pugh A grade subgroup,the Child-Pugh B grade subgroup exhibited higher APTT,PT and TT levels and lower FIB level(all P<0.05).Conclusion Testing the coagulation four items in cirrhosis patients could provide a reliable basis for disease diagnosis and accurately determine the severity of the disease.