慢性乙肝患者凝血功能与临床分型及乙肝病毒脱氧核糖核酸定量检测的关系  

Relationships between blood coagulation function and clinical grading of chronic hepatitis B as well as serum contents of HBV DNA

作　　者：郑璟 马锦霞[2] 彭燕燕[2] 陈乐川[2] 吴新伟[3] 杨霞 

机构地区：[1]中山大学中山医学院生物化学教研室,广东广州510080 [2]汕头市中心医院检验科 [3]广州市疾病预防控制中心

出　　处：《中国校医》2017年第9期650-651,654,共3页Chinese Journal of School Doctor

基　　金：广东省自然科学基金(2014A030313073;2016A030311035);广东省高等学校高层次人才项目;广东省省级科技计划项目(2017A020215075)

摘　　要：目的探讨慢性乙型肝炎、肝硬化患者凝血功能与临床分型及乙肝病毒脱氧核糖核酸(HBV DNA)定量检测的关系。方法选取205例慢性乙型肝炎及肝硬化患者为观察组,同时选取44名健康体检者为对照组。比较各临床分型患者组的凝血酶原时间(PT)、国际标准化比值(INR)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)和血小板(PLT),并分析HBV DNA阴性和阳性患者各凝血指标的差异。结果 PT随着临床分型加重而升高,FIB则反之下降、INR和APTT在重度慢性乙型肝炎及肝硬化组显著增加,PLT只有在肝硬化患者中显著下降,统计学差异显著(P<0.05)。与HBV DNA阴性患者比较,阳性患者PT明显升高,FIB和PLT显著下降。结论慢性乙肝患者凝血功能障碍随着临床分型加重逐渐加重。当HBVDNA定量阳性时PT显著延长,FIB,PLT显著降低,应注意监测凝血功能变化,防止出现严重出血。Objective To investigate the relationships between the coagulation function and clinical grading of hepatitis B as well as the serum contents of hepatitis B virus（HBV） DNA in patients with chronic hepatitis B and liver cirrhosis.Methods A total of 205 patients were selected as a case group and 44 healthy people as a control group. The case group was further divided into different clinical grading subgroups, and the patients in the different clinical grading subgroups were compared regarding prothrombin time（PT）, international normalized ratio（INR）, fibrinogen（FIB）, activated partial thromboplastin time（APTT） and platelet（PLT）. The different HBV DNA contents were also analyzed regarding these parameters of coagulation function.Results With the clinical grading（from slight to serious）, PT was significantly in-creased and FIB was significantly reduced. INR and APTT in the severe chronic hepatitis B and liver cirrhosis patients were significantly increased. PLT only decreased significantly in the patients with liver cirrhosis（P〈0.05）. Compared with the pa-tients with negative HBV DNA, the patients with positive HBV DNA had significantly increased PT and significantly re-duced FIB and PLT. Conclusion The abnormality of blood coagulation function in the patients with chronic hepatitis B and liver cirrhosis increases with the clinical grading. There is a correlation between PT, FIB, PLT and HBV DNA. When HBV DNA is quantitatively positive, the attention should be paid to monitoring the function of coagulation in order to pre-vent severe bleeding.

关 键 词：肝硬 乙型 慢性 肝炎病毒 乙型 DNA 病毒/血液 凝血酶原时间 

分 类 号：R446[医药卫生—诊断学]