SLE患者凝血功能检测与系统性红斑狼疮病程发展的相关性分析  

Correlation analysis between coagulation function test and progression in systemic lupus erythematosus

作　　者：汪雅婷 周廷栋[1] 程娟[1] 管世鹤[1] WANG Yating;ZHOU Tingdong;CHENG Juan;GUAN Shihe(Department of Clinical Laboratory,Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230601,China)

机构地区：[1]安徽医科大学第二附属医院检验科,合肥230601

出　　处：《检验医学与临床》2018年第14期2036-2038,2042,共4页Laboratory Medicine and Clinic

基　　金：安徽省教育厅省级教学质量工程"临床检验诊断学"项目(2016jxtd059)

摘　　要：目的探讨系统性红斑狼疮(SLE)患者凝血功能的改变以及其与病程发展之间的关系。方法收集2014年8月至2016年12月在该院确诊为SLE患者126例为SLE组,根据SLE疾病活动度评分(SLEDAI-2000评分)将SLE患者分为无活动、轻度活动、中度活动、重度活动4组。对其入院治疗前的血栓与凝血指标作回顾性分析,包括凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶原活动度(PT%)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、血浆D-二聚体(D-D)、纤维蛋白原降解产物(FDP)。选择健康体检者30例为对照组,应用全自动血凝分析仪Sysmex CS-5100对以上项目进行检测,并运用统计软件SPSS23.0进行数据分析。结果 SLE组血浆PT%明显低于对照组,而APTT、D-D、FDP与对照组比较明显增高,差异有统计学意义(P<0.05);无活动组与中度活动组间PT%比较,差异有统计学意义(P=0.004);无活动组与轻度活动组的APTT比较,差异有统计学意义(P=0.038),D-D在轻度活动组与重度活动组之间,差异有统计学意义(P=0.032);D-D、FDP与患者SLEDAI-2000评分呈正相关(P<0.05)。结论 SLE患者凝血功能紊乱,总体呈高凝状态。疾病活动度与高凝状态呈正相关。联合检测PT、APTT、TT、D-D以及FDP,对SLE发展中血栓的形成有较好的提示作用,并对SLE疾病的严重程度的判断及进展有较好的预测作用。Objective To investigate the change of coagulation function in patients with systemic lupus erythematosus and its relationship with the development of disease.Methods A total of 126 cases of diagnosed patients with systemic lupus erythematosus（SLE）were collected from August 2014 to December 2016 in the hospital.At the same time,30 healthy cases were selected as control group.The illness status of SLE patients was divided to four groups by SLEDAI-2000 score：no activity group,mild group,moderate group and severe group.The data of thrombosis and hemostasis testing collected before the treatment were retrospectively analyzed,such as prothrombin time（PT）and PT-international standardization ratio（INR）,prothrombin activity（PT%）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（FIB）,plasma D-dimer（D-D）and fibrinogen degradation products（FDP）.Results The differences of PT%,APTT,D-D and FDP between SLE group and the control group were statistically significant（P〈0.05）.The PT% of SLE patients in the no activity group was significantly lower than those in the moderate group（P=0.004）.And there was a significant difference in APTT between no activity group and mild group（P=0.038）.The difference of D-D level between mild group and moderate group had statistical significance（P=0.032）.In addition,D-D and FDP were positively correlated with the patients′SLEDAI-2000.Conclusion The coagulation function of patients with SLE might be in a state of disordered state.The activity degree of disease is positively correlated with high coagulation.Combined detection of PT,APTT,TT,D-D and FDP has clinical significance for disease development in SLE patients.

关 键 词：凝血功能 系统性红斑狼疮 疾病活动度 

分 类 号：R446[医药卫生—诊断学]