凝血因子检测对肝脏疾病的临床应用

Clinical application of coagulative factors on hepatic diseases

[目的 ]探讨肝脏疾病对凝血机制和纤溶活化功能的影响 ,分析其与肝脏损害程度的关系。[方法 ]采用ACL - 2 0 0型美国库尔特全自动血凝仪分别检测肝炎 33例 ;肝硬化 4 0例 ;肝癌 2 8例 ;正常人 4 0例 ,血凝血酶原时间 (PT)、活化部分凝血活酶时间 (APTT)和纤维蛋白原 (FIB ) ;采用胶体金方法测定血浆D -二聚体。[结果 ]肝炎组的PT(1 3.6± 1 .0 6 )s ,APTT (32 .4± 4 .5 7)s ,FIB(2 .5 7± 0 .4 6 )g/L ,D -二聚体 (0 .89± 0 .2 2 )mg/L ;肝硬化组PT (1 7.7± 5 .6 0 )s ,APTT(4 3.4± 1 3.3)s,FIB (2 .1 0± 0 .88)g/L ,D -二聚体 (2 .4 6± 0 .6 1 )mg/L ;肝癌组PT(1 5 .0 5± 2 .74 )s,APTT (36 .8± 5 .5 5 )s ,FIB(3.5 0± 1 .1 6 )g/L ,D -二聚体 (2 .31± 0 .8)mg/L ;它们与正常组PT(1 3.0 2± 0 .6 2 )s ;(APTT32 .0± 2 .0 )s;FIB (2 .81± 0 .78)g/L ;D -二聚体 (0 .4 5± 0 .1 1 )mg/L比较有不同程度的差异。 [结论 ]不同病程肝脏疾病患者PT、APTT、FIB、D -二聚体均可异常 ,其中肝硬化患者的各项指标变化最为显著。

To study the relationship between the coagulative factors of sera and different hepatic diseases. Acl-200 automatic coagulometer was used to detect partial thromboplastin time test(APTT)?prothrombin time(PT)?fibrinogen(Fib) and the concentration of D-dimei. The coagulation insufficiency and fibrinolytic activation existed in various degrees of all patients with different hepatic diseases. PT, APTT, FIB, D-dimer were respectively (13.6±1.06)s, (32.4±4.57)s, (2.57±0.46)g/L, (0.89±0.22) mg/L in patients with hepatitis, (17.7±5.60)s,(43.4±13.3)s,(2.10±0.88)g/L,(2.46±0.61)mg/L in patients with liver cirrhosis, (14.55±2.74)s,(34.8±5.55)s, (3.50±1.16)g/L, (2.31±0.8) mg/L in patients with liver cancer,(13.02±0.62)s, (32.0±2.0)s, (2.81±0.78)g/L,(0.45±0.11) mg/L in normal persons. There were significant differences among the groups of hepatitis, hepatocirrhosis , liver cancer and normal ( P <0.05 or P <0.01). The values of D-dimer from hepatitis were not significantly different with those from normal subjects, ( P >0.05); In contrast, increased levels of Fib ( P <0.01) were detected in 28 liver cancer patients. [Conclusion] Abnormal levels of PT, APTT, FIB and D-dimer were detected in patients with different hepatic diseases.