急性病毒性肝炎患者凝血四项、血脂指标水平及其预后评估价值分析  

Analysis of Four Items of Blood Coagulation and Blood Lipid In-dexes and Their Prognostic Evaluation Value in Patients with Acute Viral Hepatitis

作　　者：武云慧[1] 董敬超 张雪棉[2] 曹立华[3] 张继东[1] 苗亮[3] WU Yunhui;DONG Jingchao;ZHANG Xuemian;CAO Lihua;ZHANG Jidong;MIAO Liang(Department of Laboratory,the Third Hospital of Qinhuangdao City,Qinhuangdao,Hebei 066000,China;Department of Ultrasound Imaging,the Third Hospital of Qinhuangdao City,Qinhuangdao,Hebei 066000,China;Department of Hepatology,the Third Hospital of Qinhuangdao City,Qinhuangdao,Hebei 066000,China)

机构地区：[1]秦皇岛市第三医院检验科,066000 [2]秦皇岛市第三医院超声影像科,066000 [3]秦皇岛市第三医院肝病科,066000

出　　处：《临床误诊误治》2024年第11期52-57,共6页Clinical Misdiagnosis & Mistherapy

基　　金：秦皇岛市科学技术研究与发展计划项目(202005A023)。

摘　　要：目的分析急性病毒性肝炎(AVH)患者凝血四项、血脂指标水平及其评估预后的价值。方法选取2020年1月1日至2022年1月31日收治的300例AVH作为研究组,300例体检健康人员作为对照组。比较2组一般资料、凝血四项[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)、血脂指标[总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)]。研究组均行常规抗病毒、护肝治疗,比较研究组不同治疗效果患者治疗前后凝血四项、血脂指标,并分析治疗前凝血四项、血脂指标与治疗效果的相关性及预测治疗效果的价值。结果研究组外周血PT、APTT、TT长于对照组,FIB、TC、HDL-C、LDL-C水平低于对照组,TG水平高于对照组(P<0.01)。研究组治疗效果为无效患者治疗前、治疗后外周血PT、APTT、TT长于有效、显效患者,有效患者长于显效患者(P<0.05);FIB、TC、HDL-C、LDL-C水平低于有效、显效患者,有效患者低于显效患者,TG水平高于有效、显效患者,有效患者高于显效患者(P<0.05);研究组治疗后外周血PT、APTT、TT、TG水平与治疗效果呈负相关,FIB、TC、HDL-C、LDL-C与治疗效果呈正相关(P<0.05,P<0.01);治疗前凝血四项与血脂指标联合预测AVH患者治疗效果的曲线下面积为0.937(95%CI为0.903,0.962),预测敏感度、特异度分别为85.21%、88.61%,明显优于凝血四项、血脂指标单独预测(P<0.01)。结论AVH患者凝血四项、血脂指标存在明显异常,且治疗前凝血四项与血脂指标联合检测在预测治疗效果方面具有较高价值。Objective To analyze the levels of four items of blood coagulation and blood lipid indexes in patients with acute viral hepatitis(AVH)and to evaluate their prognositc evaluation value.Methods A total of 300 patients with AVH admitted from January 1,2020 to January 31,2022 were selected as the research group and 300 healthy subjects under-going physical examination as the control group.The general data,four items of blood coagulation[prothrombin time(PT),acti-vated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],blood lipid indexes[total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and triglyceride(TG)of the two groups were compared.The research group received routine antiviral and liver protection therapy.Four items of blood coagula-tion and lipid indexes were compared before and after treatment in patients with different therapeutic effects in the research group,and the correlation of four items of blood coagulation and lipid indexes before treatment with the therapeutic effect as well as their value for predicting the therapeutic effect was analyzed.Results The levels of PT,APTT and TT in peripheral blood of the research group were higher than those of the control group,the levels of FIB,TC,HDL-C and LDL-C were lower than those of the control group,and the levels of TG were higher than those of the control group(P<0.01).In the research group,the peripheral blood PT,APTT and TT of the ineffective patients were longer than those of the effective and obviously effective patients before and after treatment,and longer in the effective patients than in the obviously effective patients(P<O.05).The levels of FIB,TC,HDL-C and LDL-C were lower than those of effective and obviously effective patients,and lower in the effective patients than the obviously effective patients,while the levels of TG were higher than those of effective and obvi-ously effecitve patients,and higher in effective patients than in obviously effective patients(P<0.05).In

关 键 词：急性肝炎 病毒性 凝血酶原时间 凝血酶时间 纤维蛋白原 总胆固醇 高密度脂蛋白胆固醇 相关性 预测价值 

分 类 号：R512.62[医药卫生—内科学]