急性胰腺炎凝血功能变化及疾病严重程度和预后的关系研究

目的 探讨急性胰腺炎患者凝血功能变化及疾病严重程度和预后的关系。 方法 选择2013年1月—2014年6月收治的急性胰腺炎患者67例，设为观察组，并将患者分为轻型组(MAP组)和重型组(SAP组)以及多器官功能障碍综合征(MODS)组和非MODS组。另选择同期于该院体检的健康志愿者35例作为对照组，比较各组凝血功能指标凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、纤维蛋白原浓度(FIB)、D-二聚体(D-D)变化，分析其与急性生理学与慢性健康状况评分(APACHE Ⅱ)的相关性。 结果 观察组多个凝血功能指标及APACHEⅡ评分显著高于对照组，BPC显著低于对照组(P＜0.05)；SAP组多项凝血功能指标及APACHEⅡ评分显著高于MAP组，BPC显著低于MAP组(P＜0.05)；MODS组多项凝血功能指标及APACHEⅡ评分显著高于非MODS组，BPC显著低于非MODS组(P＜0.05)；凝血功能指标PT、APTT、FIB、D-D均与APACHEⅡ评分呈显著正相关，BPC与APACHEⅡ评分呈显著负相关(P＜0.05)。 结论 急性胰腺炎患者存在凝血功能障碍，且与疾病的严重程度和预后密切相关，具有重要的临床意义。 

Changes of blood coagulation function in patients with acute pancreatitis and its relationship with the severity and prognosis of disease

Objective To explore the changes of blood coagulation function in patients with acute pancreatitis and its clinical significance. Methods Total 67 cases patients with acute pancreatitis in our hospital from January,2013 to June,2014 were enrolled and assigned into observation group,and further divided into mild group(MAP group),severe group(SAP group),multiple organ dysfunction syndrome(MODS) and non-MODS group.35 healthy volunteers at the same period in our hospital were recruited as control group.Prothrombin time(PT),part of the activation of prothrombin time(APTT),concentration of fibrinogen(FIB) and D-dimer(D-D) were tested and compared.The relevance to acute physiology and chronic health evaluation(APACHEⅡ) was analyzed. Results The blood coagulation function index and APACHEⅡ score in the observation group were significantly higher than that in the control group,the BPC was significantly lower than that in the control group,the difference was statistically significance(P<0.05);The blood coagulation function index and APACHEⅡ score in SAP group were significantly higher than that in MAP group,the BPC was significantly lower than that in MAP group,the blood coagulation function index and APACHEⅡ score in MODS group were significantly higher than that in non-MODS group,the BPC was significantly lower than that in non-MODS group,the difference was statistically significance(P<0.05);Pearson correlation analysis showed that blood coagulation function index of PT,APTT,FIB and D-D were positively related to the APACHEⅡ score,while BPC was significantly negative related to the APACHEⅡ score(P<0.05). Conclusion There is blood coagulation dysfunction in patients with acute pancreatitis,it's closely associated with the severity and prognosis of diseases.