肝硬变患者血D-二聚体及血小板聚集功能变化的意义  

Alteration of serum D dimer and platelet aggregation in patients with liver cirrhosis and its clinical significance

作　　者：梁坚[1] 陈垦[1] 王婉梅[1] 郭菊美[1] 杨勤[1] 

机构地区：[1]广东医学院附属医院

出　　处：《新消化病学杂志》1997年第10期645-646,共2页

摘　　要：目的探讨肝硬变患者血浆Ｄ二聚体及血小板聚集功能的临床意义．方法肝硬变患者５９例，正常对照组５１例．分别应用ＥＬＩＳＡ双抗体夹心法及光电比浊法测定其血浆Ｄ二聚体浓度及血小板聚集功能．结果肝硬变患者血Ｄ二聚体水平较对照组的高，而血小板聚集功能较对照组的低，差异均有显著性（Ｐ＜００１）；肝硬变肝功能Ａ，Ｂ，Ｃ级者较对照组血Ｄ二聚体水平逐渐增高，而血小板聚集功能逐渐下降（Ｐ＜００１）；肝硬变出血者血浆Ｄ二聚体水平较非出血的高（Ｐ＜００１），而血小板聚集功能却较非出血的低（Ｐ＜００１）；ＨＢｓＡｇ阳性组血浆Ｄ二聚体水平较ＨＢｓＡｇ阴性组的高（Ｐ＜００５），而血小板聚集功能在二者之间差异无显著性（Ｐ＞００５）．肝硬变患者Ｄ二聚体水平与血小板聚集功能呈直线负相关（ｒ＝－０７８，Ｐ＜００１）．结论肝硬变患者体内继发纤溶活性增强，其出血倾向与体内继发纤溶亢进及血小板聚集功能下降有关，血浆Ｄ二聚体水平及血小板聚集功能可望成为监测肝硬变患者肝功能的实验室指标．AIM To study the alteration of serum D dimer and platelet aggregation in patients with liver cirrhosis and its clinical significance. METHODS Serum D dimer and platelet aggregation were measured by ELISA and photoelectric turbidimetry in 59 patients with liver cirrhosis and 50 normal subjects served as controls. RESULTS In patients with liver cirrhosis, serum D dimer level was elevated as compared with controls ( P <0 01), while platelet aggregation was significantly lower ( P <0 01). Serum D dimer was increased and platelet aggregation was decreased in class A, B, C patients ( P <0 01). Serum D dimer was increased and platelet aggregation decreased in liver cirrhosis with GI tract hemorrhage as compared with those without hemorrhage ( P <0 01, P <0 05 respectively). In patients with positive HBsAg D dimer was higher than those with negative HBsAg ( P <0 05),while platelet aggregation was unchanged ( P >0 05). Serum D dimer level was correlated negatively to platelet aggregation in patients with liver cirrhosis ( r =-0 78, P <0 01). CONCLUSION The secondary fibrinolytic activity was enhanced in patients with liver cirrhosis, and their tendency of hemorrhage was linked to the increased serum D dimer and decreased platelet aggregation. Serum D dimer and platelet aggregation may be used as laboratory markers for the severity of liver cirrhosis.

关 键 词：肝硬变 血液 D-二聚体 血小板聚集功能 

分 类 号：R575.202[医药卫生—消化系统]