重症急性胰腺炎凝血功能紊乱与病情严重度及预后的关系  

Relationship between Coagulation Dysfunction and Severity and Prognosis in Severe Acute Pancreatitis

作　　者：夏吉鹏[1] 崔乃强[2] 赵二鹏[2] 殷宗福[2] 李丹[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市南开医院外二科,天津300010

出　　处：《中国中西医结合外科杂志》2013年第1期3-5,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨重症急性胰腺炎(SAP)凝血功能紊乱与病情严重度及预后的关系。方法:选取发病24h内的轻型胰腺炎(MAP)组46例,SAP组44例,另选40例健康成年人作对照组,检测血浆凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、纤维蛋白原(FIB)和D-二聚体(D-D),比较其主要凝血指标的差异及主要凝血指标异常与病情严重度(APACHEⅡ)评分的关系。结果:SAP组与对照组、MAP组比较,PT、APTT、FIB及D-D差异有显著性(P<0.05);AP伴全身炎症反应综合征(SIRS)组与不伴SIRS组比较有显著性差异(P<0.01);SAP组FIB及D-D值与APACHEⅡ评分均存在直线相关关系(P<0.05)。结论:SAP患者存在血浆凝血功能紊乱,凝血功能障碍与急性胰腺炎严重度存在相关性,凝血和纤溶指标的检测对判断预后及评估病情严重度有一定指导意义。Objective To explore the relationship between coagulation dysfunction and severity and prognosis in severe acute pancreatitis. Methods Ninety patients with acute pancreatitis who had been admitted to hospital within 24 h were divided into mild acute pancreatitis（MAP） group（46 cases） and severe acute pancreatitis （SAP） group（44 cases）. There were 40 healthy people in the control group. Plasma concentrations of the prothrombin time（PT）,fibrinogen（FIB） and D-dimer（D-D） were detected. The differences of coagulation markers between the two groups were analyzed, and the relationship between coagulation markers and the severity （24 h APACHE Ⅱ ） was studied. Results Plasma concentrations of PT ,APTT, FIB and D-D in SAP group were significantly different as comparing MAP group and control group（P 〈 0.05）. There was significant difference between SIRS group and no SIRS group （P 〈 0.01）. There was significant correlation between FIB and D-D and APACHE Ⅱ score in SAP group（P 〈 0.05）. Conclusion Dysfunction of coagulation and microcirculation disturbances can be found in patients with severe acute pancreatitis. The detection of major parameters correlating with thromboxane and fibrinolysis is important for the judgement of the prognosis of patients and evaluation of the severity of the disease.

关 键 词：重症急性胰腺炎 凝血功能 APACHEⅡ评分 严重度 评估 

分 类 号：R657.51[医药卫生—外科学]