慢性乙型肝炎患者病程转归与凝血功能相关指标分析  

The relationship between the function of blood coagulation and clinical classification in patients with hepatitis B

作　　者：赵妮娜[1] 杨玉婷[1] 周芬[1] 华彦珺 顾国林[1] 陈慧[1] 胥萍[1,2] 

机构地区：[1]江苏省苏州市第五人民医院检验中心,215007 [2]江苏省苏州市感染免疫重点实验室,215007

出　　处：《检验医学与临床》2017年第3期314-316,共3页Laboratory Medicine and Clinic

基　　金：江苏省苏州市科学技术局资助项目(SYS201433;SZS201006);江苏省苏州市卫生局科技项目(LCZX201414)

摘　　要：目的探讨慢性乙型肝炎患者病情转归与凝血功能相关指标的相关性。方法收集乙型肝炎患者263例为研究对象,分为慢性乙型肝炎(89例)、乙型肝炎后肝硬化(91例)、乙型肝炎后肝衰竭(44例)和肝癌(39例)4组,采用STA-R Evolution全自动血凝分析仪分别检测凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、抗凝血酶-Ⅲ(AT-Ⅲ)、D-二聚体(D-D)和纤维蛋白降解产物(FDP),比较PT、APTT、FIB、TT、AT-Ⅲ、D-D、FDP在各组之间的差异。结果慢性乙型肝炎组PT、D-D和FDP分别为(14.63±0.22)s、(765.3±129.7)mg/L和(1.75±0.42)mg/mL,均明显低于肝硬化、肝衰竭、肝癌组,差异均有统计学意义(P<0.05);而肝衰竭组PT、D-D和FDP分别为(30.03±3.12)s、(4 828.0±798.3)mg/L和(12.83±2.44)mg/mL,均明显高于慢性乙型肝炎组、肝硬化组、肝衰竭组,差异有统计学意义(P<0.05)。TT在肝衰竭组最高,为(33.15±4.59)s,在慢性乙型肝炎组中最低,为(18.98±0.50)s,与其余各组比较,差异均有统计学意义(P<0.05)。AT-Ⅲ在肝衰竭组最低,为(28.30±2.25)%,肝硬化次之,为(55.90±2.79)%,慢性乙型肝炎组最高,为(70.36±2.81)%,肝衰竭组与其余各组比较,差异有统计学意义(P<0.05)。FIB则在肝癌组中最高,为(3.13±0.24)g/L,与其余3组比较,差异有统计学意义(P<0.05)。结论慢性乙型肝炎患者凝血功能异常与疾病的临床病程密切相关。Objective To investigate the relationship between the function of blood coagulation and clinical classification in patients with hepatitis B.Methods A total of 263 patients with hepatitis B were collected in this study,which were divided into four groups,89 cases in chronic hepatitis B group,91 cases in liver cirrhosis group,44 cases of in liver failure group,39 cases in liver cancer group.STA-R Evolution automatic blood coagulation analyzer was used to detect prothrombin time（PT）,activated coagulation time of whole blood（APTT）,fibrinogen（FIB）,thrombin time（TT）,antithrombin-Ⅲ（AT-Ⅲ）,D-dimer（D-D）and fibrin degradation products（FDP）,then the values of PT,APTT,FIB,TT,AT-Ⅲ,D-D and FDP in four groups were compared.Results In the chronic hepatitis B group,PT[（14.63±0.22）s],D-D[（765.3±129.7）mg/L]and FDP[（1.75±0.42）mg/mL]were significant lower than those of liver cirrhosis,liver failure and liver cancer group（P〈0.05）.And in the liver failure group,PT（30.03±3.12）s,D-D（4 828.0±798.3）mg/L and FDP（12.83±2.44）mg/mL were significant higher than those of the chronic hepatitis B,liver cirrhosis,liver failure group（P〈0.05）.The highest value of TT[（33.15±4.59）s]was in liver failure and the lowest value was in chronic hepatitis B[（18.98±0.50）s].The differences between liver failure group and other groups were significant（P〈0.05）.The lowest and the highest value of AT-Ⅲ among all groups was in liver failure group[（28.30±2.25）%]and chronic hepatitis group[（70.36±2.81）%]respectively.The value of AT-Ⅲin the liver cirrhosis group was（55.90±2.79）%,the difference between liver failure group and other groups were significant（P〈0.05）.The value of FIB in the liver cancer group was（3.13±0.24）g/L,which showed significant differences compared with the other three groups（P〈0.05）.Conclusion As the clinical classification of patients with hepatitis B is worse,the function of blood coagulation will be worse too.

关 键 词：乙型肝炎 凝血功能 临床分型 

分 类 号：R512.62[医药卫生—内科学]