血小板参数和凝血指标联合检测在肝硬化诊疗中的意义

目的分析联合检测血小板参数和凝血指标在肝硬化患者诊疗中的意义。方法回顾性分析收治的60例肝硬化患者,检测其血小板参数和凝血指标,同时选取60例健康人群作对照。分析血小板(PLT)、血小板比容(PCT)、血小板分布宽度(PDW)、血小板平均体积(MPV);凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT),纤维蛋白原(FIB)水平的变化。结果肝硬化C级组患者PLT、PCT水平(64.22±4.21)×109、(0.08±0.02)%]明显低于正常组(203.31±2.34)×109、(0.19±0.04)%]、肝硬化A级组患者(143.47±4.72)×109、(0.15±0.02)%]、肝硬化B级组(102.28±3.22)×109、(0.11±0.03)%]水平,PDW、MPV水平20.36±7.42(%)、14.52±3.52(fL)]明显高于正常组0.19±0.04(%)、9.64±5.41(fL)]、肝硬化A级组13.02±3.62(%)、9.75±4.27(fL)]、肝硬化B级组16.62±4.63(%)、12.38±4.62(fL)]水平;肝硬化B级组PLT、PCT水平明显低于正常组、肝硬化A级组水平,PDW、MPV水平明显高于正常组、肝硬化A级组;肝硬化A级组PLT、PCT水平明显低于正常组,PDW水平明显高于正常组,差异均有统计学意义(P<0.05)。肝硬化C级组患者PT、APTT、TT水平(14.62±4.211)S、(44.74±7.721)S、(18.80±6.321)S]明显高于正常组(12.11±2.34)S、(30.28±9.42)S、(15.41±4.72)S]、肝硬化A级组(13.38±4.72)S、(33.21±6.22)S、(17.32±9.32)S]、肝硬化B级组(14.19±3.22)S、(39.88±8.83)S、(18.44±11.23)S]水平,FIB水平(1.21±0.411)g/S]明显低于正常组(3.21±0.17)g/S]、肝硬化A级组水平(2.92±0.63)g/S]、肝硬化B级组水平(2.33±0.16)g/S];肝硬化B级组PT、APTT、TT水平明显高于正常组、肝硬化A级组,FIB水平明显低于正常组、肝硬化A级组水平;肝硬化A级组PT、APTT、TT水平明显高于正常组,FIB水平明显低于正常组,差异均有统计学意义(P<0.05)。结论肝硬化患者存在血小板及凝血功能异常,血小板参数和凝血指标可以反映肝硬化患者的疾病进展及预后情况,为临床诊治提供参考依据。

Significance of Combination Detection of Platelet Parameters and Coagulation Indices in Diagnosis and Treatment of Hepatic Cirrhosis

Objective To analyze the significance of combination detection of platelet parameters and coagulation indices in diagnosis and treatment of hepatic cirrhosis.Methods 60 patients with liver cirhosis in our department from April 2010 to June 2011 were detected the level of PLT,PCT,PDW,MPV,PT,TT,APTT,FIB.Results The level of PLT,PCT（64.22±4.21）×109、（0.08±0.02）%]in the group of liver cirhosis Class C were significantly lower than the normal group（203.31±2.34）×109、（0.19±0.04）%],group of Class A（143.47±4.72）×109、（0.15±0.02）%]and group of Class B（102.28±3.22）×109、（0.11±0.03）%].The level of PDW,MPV20.36±7.42（%）、14.52±3.52（fL] in the group of Class C were significantly higher than the normal group 0.19±0.04（%）、9.64±5.41（fL）],group of Class A 13.02±3.62（%）、9.75±4.27（fL）] and group of Class B 16.62±4.63（%）、12.38±4.62（fL）].The level of PLT,PCT in the group of liver cirhosis Class B were significantly lower than the normal group and group of Class A.The level of PDW,MPV in the group of liver cirhosis Class B was significantly higher than the normal group and group of Class A.The level of PT,APTT,TT（14.62±4.211）S、（44.74±7.721）S,（18.80±6.321）S]in the group of liver cirhosis Class C was significantly higher than the normal group（12.11±2.34）S、（30.28±9.42）S、（15.41±4.72）S],group of Class A（13.38±4.72）S、（33.21±6.22）S、（17.32±9.32）S] and group of Class B （14.19±3.22）S、（39.88±8.83）S、（18.44±11.23）S].The level of PLT,PCT（64.22±4.21）×109、（0.08±0.02）%] in the group of liver cirhosis Class C was significantly lower than the normal group （203.31±2.34）×109、（0.19±0.04）%],group of Class A（143.47±4.72）×109、（0.15±0.02）%] and group of Class B（2.33±0.16）g/S].The level of FIB（1.21±0.411）g/S] was significantly higher than the normal group （3.21±0.17）g/S],group of liver cirhosis Class A（2.92±0.63）g/S]and group of Class B （2.33±0.16）g/S];The level of liver cirhosis Class B was significantly higher than the normal group,group of Class A.The level of FIB was significantly lower than the normal group,group of Class A.The level of PT,TT was significantly higher than the normal group,and the level of FIB was significantly lower than the normal group.Conclusion There is abnormality of cogulative function index and platelet parameters in patients with liver cirrhosis.Platelet parameters andcogulative function index may reflect the pathogenesis condition and damage degree of liver disease.