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目的探讨急性胰腺炎(AP)凝血功能障碍及凝血纤溶功能检测对AP严重度的预测意义。方法选取六盘水安居医院住院治疗的AP患者65例,包括轻症急性胰腺炎(MAP)30例,重症急性胰腺炎(SAP)35例,另设正常对照组16例(均为体检合格者)。用全自动血凝仪于入院24 h内检测PT,APTT,Fib,D-dimer。结果 SAP组的APACHⅡ评分远高于MAP组和正常组(P<0.05);MAP组APACHⅡ评分与对照组亦有统计学差异(P<0.05);SAP组Fib和D-dimer显著高于MAP和正常对照组(P<0.05),该2指标MAP组均高于对照组(均P<0.05)。急性胰腺炎APACHE评分与PT,APTT,FIB,D-dimer多元回归示:回归系数Fib为0.942(P=0.030);D-dimer为0.014,(P=0.038),Fib,D-dimer与AP严重程度呈正相关。结论 Fib,D-dimer可早期预测评估急性胰腺炎的严重程度。
Objective To investigate the predictive value of coagulation dysfunction and coagulation and fibrinolytic function on the severity of AP in acute pancreatitis (AP). Methods Sixty-five AP patients hospitalized in Liupanshui Habitat Hospital were selected, including 30 cases of mild acute pancreatitis (MAP), 35 cases of severe acute pancreatitis (SAP) and 16 cases of normal control group (all of whom were physical examination). Detect PT, APTT, Fib and D-dimer within 24 hours after admission with automatic coagulometer. Results APACH Ⅱ score in SAP group was significantly higher than that in MAP group and normal group (P <0.05). APACH Ⅱ score in MAP group was also significantly different from that in control group (P <0.05). Fib and D-dimer in SAP group were significantly higher than MAP and The normal control group (P <0.05), the two indicators MAP group were higher than the control group (P <0.05). Acute pancreatitis APACHE score and PT, APTT, FIB, D-dimer multiple regression showed: regression coefficient Fib was 0.942 (P = 0.030); D-dimer was 0.014 (P = 0.038), Fib, D-dimer and AP serious The degree is positively correlated. Conclusion Fib, D-dimer can be used to predict the severity of acute pancreatitis.