肝病患者凝血酶原时间报告方式的评价

目的 评价凝血酶原时间（PT）作为判断肝病患者细胞损伤程度实验指标的两种报告方式。方法 选择肝病患者104例，其中肝炎肝硬化37例，慢性肝炎32例，肝癌36例，急性肝炎35例。30例口服华法林病人做对照组。采用ISI值不同的2种凝血活酶试剂进行PT测定。结果 急性黄疸性肝炎患者，二种凝血活酶试剂测定的INR结果有显著性差异；慢性活动性肝炎、肝硬化、肝癌患者，二种凝血活酶试剂测定的国际标准化比值（INR）结果无明显差异。急性黄疸性肝炎、肝癌患者，二种凝血活酶试剂测定的活动度（PTA）结果有显著性差异。结论 目前尚不能否定INR可作为肝病病情估计时的门标准化报告方式；PT并不是评价肝病病情的最佳指标；PTA仍为目前门作为肝病病情估计时的首选报告方式。

The evaluation of indices for prothrombin time in patients with hepatic diseases

Objective To evaluate two indices for prothrombin time as end point to determine the cell impairment degree of patients with hepatic disease. Methods 140 patients with hepatic diseases were chosen. Of which, the number of patients with hepatitis and cirrhosis is 37 cases, with chronic hepatitis is 32 cases, with liver cancer is 36 cases, with acute hepatitis is 35 eases. 30 patients who take orally the Warfarin were used as control group. Determination of PT was performed by using 2 thromboplastins with different ISI values. Results For patients with acute icterohepatitis, there is significant difference between INR results determined using two thromboplastins; for patients with chronic active hepatitis,cirrhosis and hepatic carcinoma, there is no significant difference between INR results determined using two thromboplastins. For patients with acute icterohepatitis and hepatic carcinoma, there is significant belavccn PTA results determined using two thromboplastins; and for patients with chronic active hepatitis and hepatic cirrhosis, there is no significant difference between PTA results determined using two thromboplastins. Conclusion At present time, we cannot deny that INR can be used as standardized index of PT to estimate the state of hepatic diseases; PT is not the best cndpoint to evaluate the state of hepatic diseases. PTA is still the preferred index for PT to evaluate the state of hepatic diseases.