结核病患者凝血功能的变化及意义

目的观察结核病患者治疗前后凝血功能的变化和结核病不同分型之间凝血指标的差异，探讨其临床意义。方法采用CA-50半自动凝血分析仪测定结核病患者611例，其中继发性肺结核患者330例、结核性胸膜炎患者94例、结核性腹膜炎患者72例和结核性脑膜炎患者115例的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（Fbg）和凝血酶时间（TT）。用Ac．T diff2血球分析仪计数血小板（PLT）。结果结核病患者Fbg、PLT升高，TT延长（P〈0．01），PT、APTT与对照组比较差异无统计学意义（P〉0．05）。经常规化疗和对症治疗后，结核病患者好转组Fbg、PLT、TT明显降低（P〉0．05），结核病患者未好转组指标无变化，仍高于正常人（P〈0．01）。继发性肺结核患者330例PT延长（P〈0．05），结核性脑膜炎患者115例PT缩短（P〈0．05），结核性胸膜炎94例患者和结核性腹膜炎72例患者的TT延长并高于其他两组（P〈0．01）。结论结核病患者凝血指标发生变化并与治疗效果相关，不同型结核病患者凝血指标也有显著差异，可作为结核病诊断、监测治疗效果和预后的辅助指标。

Changes and significances of hemoglutanation in patients with tuberculosis

Objective To investigate the changes and significances of hemoglutanation in patients with tuberculosis before and after treatment. Methods CA-50 hemoglutanation analyzer was used to measure prothrombin time （PT）, activated partial thromboplastin time （APTT）, thrombin time （TT）, and fibrinogen （Fbg） in 611 tuberculosis samples, including 330 secondary tuberculosis samples, 94 tubercular pleurisy samples, 72 tubercular peritonitis and 115 tubercular meningitis samples. Platelet counting （PLT） was measured by Ac.Tdiff2 corpuscle analyzer. 50 healthy persons were set as a reference group. Results In tuberculosis patients, Fbg contents and PLT counting increased, TT prolonged （P 〈0.01）, PT and APTT showed no significant differences with the reference group （P 〉0.05）. After chemo-treatment and heteropathy, Fbg contents and PLT counting decreased, and TT shortened （P 〈0.05）among the healing group, while these indexes remained unchanged among the unhealing group. PT time prolonged （P 〈0.01）in 330 secondary tuberculosis samples; PT time shortened （P 〈0.05）in 115 tubercular meningitis samples; and TT time prolong in 94 tubercular pleurisy and 72 tubercular peritonitis samples were greater than in the other 2 groups （P 〈0.01）. Conclusion Hemoglutanation of tuberculosis varies with treatment effects, and it shows significant difference among different types of tuberculosis. Therefore, hemoglutanation can serve as an auxiliary diagnosis and prognosis index for tuberculosis disease.