肝硬化患者凝血、抗凝及纤溶系统变化的临床研究  

Clinical study on changes of coagulation, anticoagulation and fibrinolysis system in patients with liver cirrhosis

作　　者：汪燕云 程莲 何鑫 裴建赢 李燕平[3] Wang Yan-yun;Cheng Lian;He Xin;Pei Jian-ying;Li Yan-ping(The First School of Clinical Medicine,Lanzhou University,Lanzhou 730000,China;Research Center,Gansu Province Maternal and Child Health Care Hospital,Lanzhou 730050,China;Department of Clinical Laboratory,The First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]甘肃省妇幼保健院科研中心,甘肃兰州730050 [3]兰州大学第一医院检验科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2022年第1期56-59,63,共5页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的评价肝硬化患者凝血、抗凝及纤溶系统的变化。方法选取肝硬化患者68例和健康者30例分别作为观察组和对照组。分析2组血浆中凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、凝血因子、血管性血友病因子(VWF)抗原、抗凝血酶(AT)、蛋白C(PC)、蛋白S(PS)、纤维蛋白(原)降解产物(FDP)、D-二聚体(DD)及纤溶酶原(PLG)活性的差异,分析上述指标与Child-Pugh肝功能分级的关系。结果与对照组比较,观察组血浆PT、APTT、TT、FDP、DD、FⅧ及VWF均升高,差异具有统计学意义(P<0.05);FIB、AT、PC、PS、PLG及F(Ⅱ、Ⅴ、Ⅶ、Ⅺ)均降低,差异具有统计学意义(P<0.05)。随着Child-Pugh肝功能分级的增高,PT、APTT、TT、VWF、FDP、DD呈现升高趋势,FIB、F(Ⅱ、Ⅴ、Ⅶ、Ⅺ)、AT、PC、PS、PLG呈现下降趋势,FⅧ无明显变化,各级间差异无统计学意义(P>0.05)。结论检测肝硬化患者凝血、抗凝及纤溶指标可以预测患者的病情严重程度及预后,对指导治疗具有重要临床价值。Objective To evaluate the changes in coagulation,anticoagulation and fibrinolysis system in patients with liver cirrhosis.Methods 68 patients with liver cirrhosis and 30 healthy subjects were selected as the observation group and the control group.Analyzed were differences in two groups of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),coagulation factors,von Willebrand factor(VWF)antigen,antithrombin(AT),protein C(PC),protein S(PS),fibrinogen degradation product(FDP),D-dimer(DD)and plasminogen(PLG)activity,the relationship between the above indicators and Child-Pugh liver function grading.Results Compared with the control group,plasma PT,APTT,TT,FDP,DD,FⅧand VWF increased in the observation group,the difference was statistically significant(P<0.05).FIB,AT,PC,PS,PLG and F(Ⅱ,Ⅴ,Ⅶ,Ⅺ)decreased,the difference was statistically significant(P<0.05).PT,APTT,TT,VWF,FDP and DD showed an increasing trend with increasing Child-Pugh liver function grading.FIB,F(Ⅱ,Ⅴ,Ⅶ,Ⅺ),AT,PC,PS,PLG showed a downward trend,there was no significant change in FⅧ,no statistical significance between the levels(P>0.05).Conclusion The detection of coagulation,anticoagulation and fibrinolytic indexes in patients with liver cirrhosis could predict the severity and prognosis of patients,having an important clinical value for guiding treatment.

关 键 词：肝硬化 凝血系统 抗凝系统 纤溶系统 CHILD-PUGH肝功能分级 

分 类 号：R446.1[医药卫生—诊断学]