重症急性胰腺炎患者凝血和纤溶功能变化及其临床意义

目的探讨凝血和纤溶功能变化在重症急性胰腺炎(SAP)的病情的评估及预后中应用价值。方法选择发病24h内入院的急性胰腺炎(AP)患者106例,其中MAP组65例,SAP组41例,同时选择健康体检者50例,分别检测凝血与纤溶功能指标PT、APTT、FIB与D-D水平。结果 MAP组与SAP组患者PT、APTT、FIB与D-D的水平较对照组轻度升高,但无统计学意义(P>0.05),SAP组与对照组及MAP组相比较均显著增高,差异有统计学意义(P<0.05);SAP组PT、APTT、FIB及D-D值与APACHEⅡ评分均存在线性正相关,相关系数r分别为0.82、0.83、0.86和0.84(P<0.05);与非MODS组相比,MODS组PT、APTT、FIB及D-D值均显著升高,差异具有统计学意义(P<0.05)。结论凝血与纤溶指标的检测有助于评估SAP的病情与预后,对防止疾病进展和降低死亡率具有指导意义。

Clinical significance of detected coagulation and fibrinolysis function in severe acute pancreatitis

Objective To explore the clinical application value of detected coagulation and fibrinolysis function in the severity and prognosis of severe acute pancreatitis(SAP).Methods The levels of PT,APTT,FIB and D-D were detected in 106 patients with acute pancreatitis(AP) who were admitted in 24 h and 50 healthy people.All the patients were divided into two groups: mild acute pancreatitis(MAP) group(N=65) and SAP group(N=41).Results The level of PT,APTT,FIB and D-D in MAP group were higher than those in healthy controls,but there was no significant difference between them(P>0.05),and they were significantly higher in SAP group than those in MAP group and control group(P<0.05).The score of APACHE Ⅱ was positively correlative with the levels of PT,APTT,FIB and D-D in SAP group,and the correlation coefficient was 0.82,0.83,0.86 and 0.84,respectively(P<0.05).There was significant difference on plasma PT,APTT,FIB and D-D between MODS group and non-MODS group(P<0.05).Conclusion Detection of coagulation and fibrinolysis function can contribute to the severity and prognosis of SAP,and it has directive significance in preventing disease progression and reducing death rate.