肝硬化患者凝血功能、血小板参数、网织红细胞参数的变化与Child-Pugh分级的关系

目的了解肝硬化患者凝血功能、血小板参数、网织红细胞参数的变化与Child-Pugh肝功能分级的关系。方法分别采用全自动血液分析仪和全自动血凝仪测定163例肝硬化患者和50例健康对照者的凝血功能指标(PT、APTT、Fig、TT),血小板参数(PLT、MPV、PDW、PCT)和网织红细胞参数(RET#、RET%、IRF)。比较肝硬化组与对照组、肝硬化Child-Pugh分级后组间凝血功能、血小板参数和网织红细胞参数的变化。结果与对照组比较,肝硬化患者Fig降低,PT、APTT、TT延长,PLT、PCT下降,MPV、PDW升高,RET计数、RET%、IRF升高,差异有统计学意义(P0.05);Fig随着Child-Pugh等级上升逐渐降低,PT、APTT、TT随着Child-Pugh等级上升逐渐延长,PLT、PCT随着Child-Pugh等级上升逐渐下降,MPV、PDW随着ChildPugh等级上升逐渐升高,RET计数、RET%、IRF随着Child-Pugh等级上升逐渐升高(P0.05)。结论肝硬化患者存在凝血功能、血小板参数及网织红细胞参数异常,其凝血功能,血小板参数及网织红细胞参数的变化与Child-Pugh肝功能分级有密切相关,是判定肝脏损害程度、出血倾向及骨髓造血功能的重要指标。

Relationship between changes of coagulation function,platelet parameters and reticulocyte parameters with Child-Pugh grade in patients with liver cirrhosis

Objective To understand the relationship between the changes of coagulation function ,platelet parameters and retic‐ulocyte parameters with the Child‐Pugh grade in the patients with liver cirrhosis .Methods The coagulation function index (PT , APTT ,Fig ,TT) ,platelet parameters(PLT ,MPV ,PDW ,PCT) and reticulocyte parameters(RET# ,RET% ,IRF) were detected in 163 patients with liver cirrhosis and 50 healthy controls by using the automatic hematological analyzer and the automatic blood co‐agulation analyzer .Then the changes of coagulation function ,platelet parameters and reticulocyte parameters were compared be‐tween the liver cirrhotic group and the control groups ,and among different Child‐Pugh grade groups .Results Compared with the control group ,Fig in the liver cirrhosis group was declined ,PT ,APTT and TT were prolonged ,PLT and PCT was decreased ,while MPV and PDW were elevated ,RET count ,RET% and IRF were increased ,the difference between the two groups were statistically significant(P<0 .05);Fig was gradually declined with the Child‐Pugh grade elevation ,PT ,APTT and TT were prolonged ,PLT and PCT was decreased ,while MPV and PDW were increased with the Child‐Pugh grade elevation ,and RET count ,RET% and IRF were increased (P<0 .05) .Conclusion The blood coagulation disturbance and abnormality of platelet parameters and reticulocyte parameters exist in the patients with liver cirrhosis .The changes of coagulation function ,platelet parameters and reticulocyte param‐eters are closely related to the Child‐Pugh classificatione ,which are the important indicators for judging the liver damage ,bleeding tendency and bone marrow hematopoietic function in the patients with liver cirrhosis .