凝血常规在各型乙型病毒性肝炎、乙型肝炎后肝硬化患者中的检测及其临床意义

目的探讨凝血常规在各型乙型肝炎、乙型肝炎后肝硬化患者病变严重程度的临床价值。方法收集乙型肝炎、乙型肝炎后肝硬化患者样本75例,健康对照者样本20例,采用凝固法检测凝血酶原时间(PT)、国际标准化比值(INR)、凝血酶原时间活动度(PTA)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)等指标。结果 PTI、NR、PTA、APTT在各型乙型病毒性肝炎、肝硬化Child-Pugh A、B、C间两两比较差异均有统计学意义(P0.01,P0.05),FIB对照组、急性肝炎、肝硬化、重症肝炎组中逐渐减低,但各组间无显著性差异(P0.05)。对PTA异常程度与预后进行了比较,结果显示PTA与重症肝炎、肝硬化预后有显著的相关性(pearman相关系数为0.41,P0.05),当PTA水平在20%-30%之间时,病死率为33.33%(1/3)预后不良,PTA低于20%时,病死率高达57.14%(4/7),PTA低于10%时病死率达100.00%。结论凝血常规尤其是PTA异常程度可成为判定重症肝炎、肝炎后肝硬化严重程度及预后的指标之一。

Clinical Significance and Detection of Coagulation Index for Patients Suffering Various Hepatitis B and Liver Cirrhosis

Objective Studying the clinical significance of coagulation index in different Hepatitis B and severity degree of liver cirrhosis.Methods Samples from seventy-five patients suffering hepatitis B and liver cirrhosis were collected.Samples from twenty healthy persons were collected for the purpose of case-control comparisons.Prothrombin time（PT）,international normalized ratio（INR）,prothrombin time activity percentage（PTA）,activated partial thromboplastin time（APTT）and fibrinogen（FIB）were detected with the methods of clotting assay.Results Statistical significances were found in the comparisons of PT、INR、PTA、APTT among various Hepatitis B and Child-Pugh A,B,C for patients with liver cirrhosis（P0.01,P0.05）.Although the decreasing of FIB concentration was observed in control group,acute hepatitis group,liver cirrhosis group and serious hepatitis group,there was no obvious difference found among different groups（P0.05）.A significant correlation was found between PTA and the prognosis of serious hepatitis and liver cirrhosis（Pearman coefficient 0.41,P0.05）.When the level of PTA is in 20%-30%,lower than 20% and lower than 10%,the mortality rate is 33.33%,57.14%,100%,respectively.Conclusion Coagulation index serves as an important indicator for diagnosing various hepatitis B and the severity degree of liver cirrhosis.