急性胰腺炎血浆凝血功能检测的临床意义

Clinical significance of detecting coagulation function in acute pancreatitis.

目的 探讨 14 6例急性胰腺炎 (AP)病人凝血系统的变化及临床意义。方法 用全自动血凝分析仪 ,检测AP组和正常对照组 (NC)的凝血酶原时间 (PT)、凝血酶原时间国际标准化指数 (INR)、部分活化凝血酶原时间 (APTT)和纤维蛋白原浓度 (FIB)。结果 轻型胰腺炎组 (MAP)与NC组比较差异无显著性 (P >0 0 5 ) ;重症胰腺炎组 (SAP)与MAP组和NC组比较有显著性差异 (P <0 0 1) ;多器官功能障碍综合征 (MODS)组与无MODS组比较有显著性差异 (P <0 0 1) ;治愈组与死亡组比较差异有显著性 (P <0 0 1) ;合并胆管病变组、合并胆囊病变组和非胆源性AP组比较差异无显著性 (P >0 0 5 ) ;在出现器官功能衰竭病人中有肝功能衰竭与无肝功能衰竭者相比差异无显著性 (P >0 0 5 )。结论 SAP病人PT、APTT和FIB值明显延长且提示预后不佳 ,PT。

Objective To explore the changes of blood coagulation system and clinical significances in 146 cases of acute pancreatitis(AP). Methods Prothrombin time (PT),international normalized ratio (INR),partially activited thromboplastin time (APTT) and fibrinogen(FIB) of 146 patients in AP and normal control (NC) group were detected by full automatic blood coagulation analyzer.Results There was no statistical difference between mild AP (MAP) group and NC group(P>0 05),but PT,APTT and FIB in severe AP (SAP) group were significiantly different compared with MAP group and NC group(P<0 01).There was significant difference between MODS group and no MODS group(P<0 01),there was also significant difference between cured group and died group(P<0 01).There was no statistical difference among cholepathia+AP group and cholecystopathy+AP group and non biliary acute pancreatitis(P>0 05).There was no statistical difference between liver failure group and no liver failure group in the patients with organ failure(P>0 05).Conclusion PT?APTT and FIB of SAP patients prolong significantly,it shows a bad prognosis.The changes of PT?APTT and FIB have no relation with cholepathia or liver dysfunction.