预防性输注新鲜冰冻血浆对纠正慢性重型乙型病毒性肝炎患者凝血功能效果探析  

Study on the prophylactic transfusion effect of fresh frozen plasma on coagulation function in chronic severe hepatitis B patients

作　　者：胡飘萍[1] 吴承高[1] 李松[1] 邹娟[1] 肖昆[1] 乐爱平[1] 

机构地区：[1]南昌大学第一附属医院输血科,江西南昌330006

出　　处：《中国输血杂志》2015年第8期937-939,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨慢性重型乙型病毒性肝炎患者预防性输注新鲜冰冻血浆(FFP)的凝血功能改善效果。方法将275名慢性重型乙型病毒性肝炎患者随机分为输血治疗组和非输血治疗组,其中输血治疗组85例,非输血治疗组190例;监测治疗前与治疗1周后患者凝血功能、肝功能和血常规等指标的变化,以探讨预防性输注FFP的临床价值。结果 1)输血治疗组治疗前和治疗后的PT和INR与非输血治疗组间差异均不具统计学意义(P>0.05);输血治疗组和非输血治疗组治疗前、治疗后的PT、APTT、INR、FIB差异均不具统计学意义(P>0.05);输血治疗组和非输血治疗组logistics回归分析均不具统计学意义(P>0.05)。2)根据受试者工作特征曲线(ROC曲线)下面积,有效纠正凝血功能的PT和INR cut-off分别为31s、2.55,其对应敏感度和特异度均>90%。结论慢性重型乙型病毒性肝炎患者常规小剂量预防性输注FFP改善凝血功能效果不佳,预防性输注FFP不是改善慢性重型乙型病毒性肝炎患者凝血功能的独立性因素,但当PT或INR达到一定阈值时输注FFP可有效改善凝血功能。Objective To investigate the prophylactic transfusion effect of fresh frozen plasma （FFP） on coagulation function in patients with chronic severe hepatitis B virus. Methods The 275 chronic severe hepatitis B patients were randomly divided into two groups： the transfusion treatment group （n = 85 ） and non transfusion treatment group （n = 190）. Changes in blood coagulation function, liver function and blood routine before treatment and 1 week after treatment were mo-nitored to investigate clinical value of the prophylactic plasma transfusion. Results There was no statistically significance in PT and INR between the transfusion treatment group or non transfusion treatment group before and after treatment （ P 〉 0. 05 ）. PT, APT＇F, INR, FIB had no differences in the transfu- sion treatment group and non transfusion treatment group before treatment or after treatment （ P 〉0. 05 ）. Logistic regression analysis was not statistically significant in two groups （ P 〉 0. 05 ）. According to the area under the receiver operating characteristic curve （ ROC curve）, the cut-off value of PT and INR for effective remedy coagulation function was 31s and 2.55, respectively, with corresponding sensitivity and specificity all above 90%. Conclusion Conventional low-dose FFP prophylactic transfusion had poor effect on ameliorating coagulation function in chronic severe viral hepatitis B patients. FFP prophylactic transfusion was not an independent factor in ameliorating the coagulation function of chronic severe hepatitis B patients, but when the PT or INR reaches a certain threshold, FFP transfusion can effectively improve the coagulation function.

关 键 词：慢性重型乙型病毒性肝炎 新鲜冰冻血浆 凝血功能 ALT AST 预防性输注 

分 类 号：R457.1[医药卫生—治疗学]