凝血四项及AT-Ⅲ、D-二聚体在肝硬化患者中的变化及临床意义  

Changes of 4 coagulation indicators and AT-Ⅲ,D-dimer in patients with liver cirrhosis and their clinical significance

作　　者：杨倩[1] 

机构地区：[1]陕西中医药大学附属医院检验科,西安712000

出　　处：《检验医学与临床》2015年第22期3371-3372,3375,共3页Laboratory Medicine and Clinic

摘　　要：目的观察凝血四项、抗凝血酶原-Ⅲ(AT-Ⅲ)与D-二聚体(D-D)在临床肝硬化患者血浆中的表达,并对其临床意义进行探讨。方法抽选收治的80例肝硬化患者作为甲组观察对象,甲组患者按照肝功能Child-Pugh分级标准对患者进行分级处理,A级21例,B级37例,C级22例;同期抽选80例健康体检者作为乙组观察对象与80例慢性乙肝患者作为丙组观察对象,分别测量各组患者凝血四项、AT-Ⅲ与D-D各项指标的水平,并进行对比分析。结果甲、丙两组患者APTT、PT、TT、D-D水平明显高于乙组,且甲、丙两组的FIB、AT-Ⅲ水平显著低于乙组,差异均有统计学意义(均P<0.05);不同肝功能分级组,其凝血四项、AT-Ⅲ与D-D水平也有所不同,且APTT、PT、TT与D-D指标水平,均呈现出逐渐上升的趋势,而FIB与AT-Ⅲ指标水平则逐渐下降。结论凝血四项、AT-Ⅲ与D-D指标检测,可较客观地反映肝硬化患者凝血的状况,便于医生准确评估患者肝脏损害严重程度,为患者的后期治疗提供有利依据。Objective To observe the expressions of plasma 4coagulation indicators,AT-Ⅲ and D-dimer（DD）in the patients with clinical liver cirrhosis and to investigate their clinical significance.Methods 80 patients with liver cirrhosis were selected as the observation subjects（group A）,including 21 cases of stage A,37 cases of stage B and 22 cases of stage C;contemporaneous 80 volunteers undergoing the healthy physical examination were taken as the observation subjects（group B）and 80 cases of chronic hepatitis B as the observation subjects（group C）.The 4coagulation indicators,AT-Ⅲ and DD levels were detected and the detection results were performed the contrastive analysis.Results The APTT,PT,TT and D-D levels in the group A and C were significantly higher than those in the group B,moreover the FIB and AT-Ⅲlevels were significantly lower than those in the group B,the differences were statistically significant（P〈0.05）;the 4coagulation indicators,AT-Ⅲ and D-D levels were different among different liver function grade groups,moreover the APTT,PT,TT and D-D levels showed a gradual upward trend,while the FIB and AT-Ⅲlevels were decreased gradually.Conclusion The detection of 4coagulation indicators,AT-Ⅲ and D-D can more objectively reflect the coagulation status in the patients with liver cirrhosis,which is convenient for doctors accurately assessing the severity of liver damage and provides a favorable basis for the late treatment of the patients.

关 键 词：肝硬化 凝血四项 AT-Ⅲ D-二聚体 

分 类 号：R575.2[医药卫生—消化系统]