凝血4项检测在评价急性胰腺炎预后中的临床意义  

Clinical Significance of Coagulation Test to Forecast the Severity Acute Pancreatitis

作　　者：程思根[1] 郭强[2] 董树强[1] 

机构地区：[1]昆明市第一人民医院消化内科,云南昆明650011 [2]云南第一人民医院消化内科,云南昆明650032

出　　处：《昆明医学院学报》2008年第1期120-124,共5页Journal of Kunming Medical College

摘　　要：目的研究凝血4项检测对预测急性胰腺炎(AP)病情的价值.方法将112例AP患者分为存活组与死亡组、非SIRS组与SIRS组、轻型组与重型组,比较各组SIRS发生情况的变化;比较非SIRS组与SIRS组C反应蛋白(CRP)的变化;比较非SIRS组与SIRS组、SIRS符合项数组与正常对照组(NC)凝血4项的变化.结果重型组SIRS发生情况比轻型组严重(P<0.05).死亡组SIRS发生情况比存活组严重(P<0.05).SIRS组CRP值高于非SIRS组(P<0.05).SIRS组凝血四项比非SIRS组延长(P<0.05).AP患者随着SIRS符合项数增加,凝血4项延长(P<0.05).结论AP患者SIRS发生情况与预后有明显关系.同时,发生SIRS的AP患者存在凝血功能紊乱,炎症反应越重,凝血系统激活越明显,预后越差.Objective To explore the value of coagulation test to forecast the severity of the acute pancreatitis （AP）. Methods 112 patients were diagnosed as AP in the First People＇ s Hospital of Kunming from January 2004 to December 2005, and 20 healthy volunteers as normal contrast group （NC）. The patients were divided into survivor and non-survivor group according to prognosis, and were divided into non-SIRS and SIRS group according to occurrence of SIRS, and patients in the survivor group were further divided into mild group （MAP） and severe group （SAP） according to scores of acute physiology and chromic health evaluation I1 （APACHE lI ）. The differences in occurrence situation of SIRS and the diagnostic criteria of SIRS were compared between survivor and non-survivor group, MAP and SAP. The differences in duration of SIRS were compared between MAP and SAP. The changes of C-reactionprtein （CRP） were compared between non-SIRS group and SIRS group. Meanwhile, the most common lab items （PT, TF, APTT and FIB） related to patients and volunteers were detected by blood coagulation analyzer. The changes of coagulation test in groups, SIRS diagnostic criteria groups were observed. Results The morbidity,diagnostic criteria,duration of SIRS in SAP were higher than those in the MAP （P 〈 0.05）. The morbidity of SIRS in non-survivor group was higher than that in survivor group, and the SIRS diagnostic criteria, themortalityinAPpatientswerehigher （P〈 0.05）. The CRP in the SIRS group was higher than that in non-SIRS group （P 〈 0.05）. Compared with non-SIRS, PT, TI＇, APTr and FIB in SIRS group prolonged （P 〈 0.05）. Compared with the volunteers, the SIRS diagnostic criteria increased, PT, TT, APTT and FIB prolonged （P 〈 0.05）. Conclusions The prognosis of AP is related to the onset, duration and diagnostic criteria of SIRS in AP. Meanwhile, there are dysfunctions of coagulation in AP patients with SIRS. The complex and whole body＇s inflammation/coagulation response are forme

关 键 词：急性胰腺炎 全身炎症反应综合征 凝血4项 

分 类 号：R576[医药卫生—消化系统]