乙型病毒性肝炎患者中末期凝血酶原时间标准化报告方式

Standardization of the prothrombin time report for patients with hepatitis B disease

目的 探讨乙型病毒性肝炎患者凝血酶原时间(PT)的标准化报告方式。方法 选择乙型病毒性肝炎患者61例,其中肝炎后肝硬化41例,慢性重型肝炎20例。20例口服华法令抗凝药患者作为对照组。采用来源不同、ISI值不同的6种凝血活酶试剂进行PT测定,以秒数、比率、活动度百分率以及国际正常化比率4种方式表示PT结果。结果 病毒性肝炎患者PT结果,当以活动度百分率和比率形式表示时,不同凝血活酶试剂之间差异没有显著性意义(F=1.289,P=0.268;F=I.992,,J=3.079),当以秒数和INR报告方式表示时,差异有显著意义(F=8.491,P=0.0001;F=2.497.P=0.031)。通过Neoplastin与其他5种试剂的PT结果作线性回归分析,当结果以活动度百分率表示时,Neoplastin与其他5种试剂之间存在高度一致性;而以秒数,比率和INR表示时,试剂之间不存在一致性。提示PT活动度百分率能使乙型病毒性肝炎中末期患者PT报告方式标准化。口服抗凝剂治疗的患者仅INR能使PT的报告方式标准化。结论 PT活动度百分率能使乙型病毒性肝炎中末期患者PT报告方式标准化,INR仅适用于抗凝治疗患者PT结果的报告。

Objective To investigate standardization of modes of FT reporting in patients with hepatitis B. Methods There were 61 patients with hepatitis B were enrolled, including 41 patients with liver cirrhosis, 20 with chronic liver failure. Control patients were on Warfarin therapy ( n = 20 ). PT test were performed using six thromboplastin reagents of different source and different ISI, and expressed in seconds ( PTs ) , ratio ( PTr ) , activity percentage ( PTp ) and International normalized Ratio ( INR ) , respectively. Results In patients with liverdisease, the mean PTp and PTr determined by using the six different thromboplastin reagents were not significantly different (F = 1. 289 , P = 0. 268; F = 1. 992, P = 0. 079) while INR and PTs were significantly different ( F = 2.497,P = 0. 031; F = 8. 491, P = 0. 0001). Moreover, the analysis of interchangeability by regression lines between Neoplastin and other five reagents showed a high conformity existed between reagents when PTp was used, while large discrepancies were found when PTr, PTs and INR were used. The results suggested that PTp was the best form of PT report for patients with hepatitis for comparison purpose. For patients on oral anticoagulant therapy, only INR standardized the PT results. Conclusions In patients with hepatitis B, activity percentage expression may provide standardization of PT report.