肝病患者凝血、纤溶指标及血小板参数检测的临床意义

目的探讨肝病患者凝血、纤溶指标和血小板参数的变化及其临床意义。方法使用贝克曼ElitePro全自动血凝分析仪和迈瑞BC-5500五分类血细胞分析仪分别检测40例健康体检人员为对照组和90例肝病组的凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(Fib)、D-二聚体,以及血小板计数(PLT)、血小板压积(PCT)、血小板分布宽度(PDW)、血小板分布体积(MPV),并比较。结果与对照组比较,肝硬化、肝癌患者的PT、APTT、TT延长,FIB降低,D-二聚体升高,差异有统计学意义(P<0.05或<0.01)。与代偿期相比,肝硬化失代偿期也存在PT、APTT、TT显著延长,FIB降低,D-dimer升高现象,差异有统计学意义(P<0.05)。与对照组比较,肝硬化失代偿期和原发性肝癌中PLT、PCT显著减少,MPV增大,差异有统计学意义(P<0.05)。结论联合检测肝病患者凝血、纤溶及血小板参数,对病情判断、出血抢救,治疗预后有重要的临床意义。

The clinical significance of detection for coagulation, fibrinolysis indexes and platelet parameter in patients with hepatopathy

Objective To investigate the changes and clinical significance for coagulation, fibrinolysis indexes and platelet parameter detection in patients with hepatopathy. Methods The serum levels of PT, APTT, Fib, D-dimer, PLT, PCT, PDW, MPV were detected by auto-hemagglutination analyzer and BC-5500 five classification blood corpuscle analyzer in 90 patients with hepatopathy and .40 healthy subjects （control group）. The examination results were compared between the two groups. Results As compared with those in control group, the PT, APTT,TT were lengthened in patients with cirrhosis or hepatic carcinoma, and FIB was decreased, however, D-dimer was increased, and there were significant differences between the two groups （ P 〈 0.05 or P 〈 0.01）. As compared with those in the patients with cirrhosis at compensation period, the PT, APTT, TT were lengthened in patients with cirrhosis at decompensation period, and FIB was decreased, however, D-dimer was increased, and there were significant differences between the two groups （ P 〈 0.05 ）. As compared with those in control group, the PLT and PCT were decreased in patients with primary liver cancer or cirrhosis at decompensation period, however, the patients＇ MPV was increased, and there were significant differences between two groups （ P 〈 0.05 ）. Conclusion The combined detection of the parameters including blood coagulation, fibrinolysis and platelet has important clinical significance for judging patients＇ condition, preventing hemorrhage and evaluating patients＇ prognosis..