血小板及PT-INR、FDP、D二聚体、PT与急性胆管炎病情程度的相关性研究  

Correlation between platelet and some coagulation indexes and the severity of acute cholangitis

作　　者：刘昶[1] 王丽[1] 谢苗荣[1] LIU Chang;WANG Li;XIE Miao-rong(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《临床和实验医学杂志》2020年第22期2441-2446,共6页Journal of Clinical and Experimental Medicine

基　　金：北京市医院管理中心临床医学发展专项——“扬帆”计划(ZYLX201802)。

摘　　要：目的分析急性胆管炎病情与血小板及部分凝血指标的关系,求证血小板及临床常用的凝血相关指标对判断急性胆管炎的病情的预测或提示意义。方法回顾性选取2012年12月至2014年8月间首都医科大学附属北京友谊医院收治的90例急性胆管炎患者为研究对象,根据东京指南将所有患者分为轻症(39例)、中症(28例)和重症(23例)组。比较各组之间血小板计数(PLT)、凝血酶原时间-国际标准化比值(PT-INR)、纤维蛋白(原)降解产物(FDP)、D-二聚体(D-D)和凝血酶原时间(PT)的差异及对判断急性胆管炎病情的敏感度和特异度。结果①PLT:急性胆管炎轻、中度组患者比重度组患者的曲线下面积为0.842,曲线下面积最高,并且灵敏度为87.9%,特异度为70.8%;轻度组患者比中、重度组患者的曲线下面积为0.739,灵敏度为97.4%,特异度为52.9%。重度患者最佳诊断分界点为131×10^9/L。②PT-INR:轻、中度组患者比重度组患者的曲线下面积为0.826,并且灵敏度为62.5%,特异度为93.9%;中度组患者比重度组患者的曲线下面积为0.769,并且灵敏度为54.2%,特异度为92.6%。轻、中度组和重度组比较时最佳分界点为1.05,中度患者与重度患者组的比较最佳分界点为1.33。两个数值的特异度随很高,但灵敏度均较低。③FDP:轻度组患者比中度组患者的曲线下面积为0.851,灵敏度81.5%,特异度76.9%,2组的最佳诊断分界点均为3.195μg/mL。④D-D:轻度组患者比中度组患者的曲线下面积为0.859,灵敏度81.5%,特异度69.2%,最佳诊断分界点分别为1.995。⑤PT:轻、中度组患者比重度组患者的曲线下面积为0.837,灵敏度62.5%,特异度93.9%;中度组患者比重度组患者的曲线下面积为0.780,灵敏度62.5%,特异度85.2%。轻、中度组和重度组比较时最佳分界点为2.20,中度患者与重度患者组的比较时最佳分界点也为2.20秒。与PT-INR相比,PT在重症组曲线下面积更高,灵敏度更高�Objective Abnormal platelet and coagulation system is often complicated by acute cholangitis,platelet and coagulopathy often heralds the deterioration.Because assuming that platelets and clinical commonly used blood coagulation related indicators to judge the condition of acute cholangitis has certain prediction or prompt significance.Studied in this paper through the retrospective study,comparison and analysis of acute cholangitis condition and platelet and part of coagulation indexes,the relationship between research hypothesis verification.Methods Chosen 90 cases of patients with acute cholangitis who were treated from as the research object December 2012 to August 2014 in Beijing Friendship Hospital.All patients were diagnosed with Tokyo guide 2013 standards.According to the Tokyo guidelines,all patients were divided into light,medium and severe groups.comparison between groups of platelet count,PT and INR,FDP,D dimer and the difference of PT and on the judgement of the sensitivity and specificity of acute cholangitis condition.Results①Platelet count:the proportion of patients with mild and moderate groups of patients of area under the curve was 0.842,the highest area under the curve,and the sensitivity was 87.9%,70.8%;Patients than in the mild group,severe area under the curve of the group of patients was 0.739,the sensitivity was 97.4%,52.9%.Optimal diagnosis for patients with severe cut-off point was 131×10^9/L.②PT-INR:The proportion of patients with mild and moderate groups area under the curve of the patients was 0.826 degrees group,and the sensitivity was 62.5%,93.9%;Patients with moderate degree of the proportion of patients with group of area under the curve was 0.769,and the sensitivity was 54.2%,92.6%.Mild,moderate and severe group when comparing the best cut-off point was 1.05,the comparison of patients with moderate and severe patients the best cut-off point of 1.33.Two Numbers with high specific degree,but the sensitivity was low.③FDP:the area under the curve,sensitivity and specificity of

关 键 词：急性胆管炎 血小板计数 凝血酶原时间-国际标准化比值 纤维蛋白(原)降解产物 D-二聚体 凝血酶原时间 

分 类 号：R575.7[医药卫生—消化系统]