肝硬化患者凝血系统常规指标和胰岛素样生长因子改变及意义

目的探讨凝血系统常规指标和胰岛素样生长因子在肝硬化病情预后中的作用,为临床诊断和治疗提供依据。方法按Child-Pugh分级标准将120例肝硬化患者分为A、B、C3级组,选择40例健康体检者作为正常对照组。测定凝血系统常规指标和胰岛素生长因子。结果（1）肝硬化组凝血因子PT、APTT水平与对照组比较均显著增高,且随着Child-Pugh积分的增高而逐渐升高（P〈0.05）;FIB水平与对照组比较显著降低（P〈0.05）,且随着Child-Pugh积分的增高而逐渐下降,A、B、C3级组间相比较也有显著性差异（P〈0.05）。（2）肝硬化组胰岛素样生长因子3项指标显著低于对照组,相比较有显著性差异（P〈0.05）;A、B、C三组IGF-Ⅰ、GIF-Ⅱ、IGFBP-3水平随Child-Pugh积分增加而呈递减趋势,显著低于对照组（P〈0.05）,A、B、C3级组间比较也有显著性差异（P〈0.05）。结论凝血系统常规指标和胰岛素样生长因子能及时准确地反映肝损害情况,可作为临床上进一步评价肝硬化分级的指标,对估测肝硬化的严重程度及预后有十分重要的临床价值。

Changes and Significance of Conventional Indicators of Coagulation System and Insulin-Like Growth Factor in Patients with Liver Cirrhosis

OBJECTIVE To investigate the effect of conventional indicators of coagulation system and insulin-like growth factor in the prognosis of liver cirrhosis, and to provide the basis for clinical diagnosis and therapy. METHOD 120 cases of liver cirrhosis were divided into A, B, C three-tier group by Child-Pugh classification standards, 40 cases of normal healthy as control group. The conventional indicators of coagulation system （PT,APTT and FIB） and insulin-like growth factor （IGF-,IGF- Ⅱ and IGFBP-3） were detected. RESULTS （1）The PT and APTT levels of the cirrhotic group＇s patients were significantly higher than that of the control group, and with the Child-Pugh score increased gradually increased （P〈0.05） ; The FIB level of the cirrhotic group＇ s patients were significantly lower than that of the control group, and with the Child-Pugh score increased gradually decreased （P〈0.05） , there were also significant differences among the A, B, C three groups（P〈0.05） . （2）The IGF-Ⅰ,GIF- Ⅱ and IGFBP-3 levels of the cirrhotic group＇ s patients were significantly lower than that of the control group, and with the Child-Pugh score increased gradually decreased（P〈 0.05） , there were also significant differences among the A, B, C three groups （P〈0.05） . CONCLUSION The conventional indicators of coagulation system and insulin-like growth factor can be timely and accurate reflection of liver damage, can be used as clinical indicators to evaluate the liver cirrhosis classification, to estimate the severity of liver cirrhosis and prognosis are very important clinical value.