血必净对乙型肝炎慢加急性肝功能衰竭早期患者凝血功能的影响

目的：探讨血必净对乙型肝炎慢加急性肝衰竭早期患者凝血功能的影响。方法选择56例乙型肝炎慢加急性肝衰竭早期患者，随机分为治疗组和对照组。对照组27例，采用内科综合治疗；治疗组29例，在内科综合治疗基础上加用血必净。检测两组患者治疗前及治疗后第3、7天的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、D二聚体（D-D）以及血小板计数（PLT）。结果两组患者治疗前PT、APTT、FIB、D-D和PLT差异无统计学意义；对照组治疗后第3、7天PLT和FIB均明显下降，与治疗前比较差异有统计学意义（P＜0．05），PT、APTT均上升，但与治疗前比较差异无统计学意义；治疗组第3天PLT和FIB均下降，PT、APTT均上升，与治疗前比较差异无统计学意义；治疗组第7天PLT、FIB、PT、APTT均恢复至治疗前水平，与对照组同期比较，治疗组PLT和FIB升高，PT、APTT缩短，D-D下降，差异有统计学意义（P＜0．05）。结论血必净可改善乙型肝炎慢加急性肝衰竭早期患者的凝血功能，减少DIC和MODS的发生。

Effects of Xuebijing injection on coagulation parameters in patients with early stage of HBV-related acute-on-chronic liver failure

Objective To investigate the effects of traditional Chinese medicine Xuebijing injection on coagulation function in patients with early stage of HBV-related acute-on-chronic liver failure. Methods Fifty-six patients were randomly divided into two groups：27 cases in control group and 29 cases in treatment group. Treatment group was given Xuebijing injection and supportive therapy,while control group received routine therapy only. Samples of venous blood were collected before therapy and on day 3 and 7 after therapy for determination of PT,APTT,FIB,D-D and PLT. Results There was no significant difference of coagulation parameters,including PT,APTT,FIB,D-D and PLT, between control and treatment groups before therapy. Compared with those before therapy,levels of PLT and FIB were decreased （P〈0.05 ）on day 3 and 7 after therapy in control group,and levels of PLT,FIB,PT and APTT were improved on day 7 in treatment group. On day 7 in treatment group,PT,APTT and D-D levels were lower than those in control group （P〈0.05）;PLT and FIB levels were significantly higher than those in control group （P〈0.05）. Conclusion Xuebijing injection can improve the coagulation function in patients with early stage of HBV-related acute-on-chronic liver failure,consequently reducing the occurrence of DIC and MODS.