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目的探讨血浆凝血因子和血小板各项参数在重症肝硬化诊断中的价值。方法随机抽取在新疆医科大学第一附属医院治疗的重症肝硬化(Child-Pugh分级)患者45例(病例组)和体检正常的健康人45例(对照组)。测定其血小板的各项参数和各凝血指标,包括血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、血小板平均分布宽度(PDW)、凝血酶原时间(PT)、凝血酶时间(TT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及凝血因子Ⅱ、Ⅴ、Ⅶ、Ⅷ、Ⅸ、Ⅹ。结果病例组及对照组PLT分别为(43.67±46.1)×109和(199.03±33.2)×109,MPV分别为(14.56±0.21)fl和(10.23±1.30)fl,PCT分别为(0.07±0.01)%和(0.27±0.11)%,PDW分别为(14.52±2.13)%和(9.89±1.01)%,病例组以上指标明显低于对照组,差异有统计学意义(P<0.05)。病例组的PT、APTT和TT较对照组均明显延长,其中病例组与对照组的时间差△PT>3s,△APTT>10s。病例组纤维蛋白原较对照组显著降低。病例组Ⅱ、Ⅴ、Ⅶ、Ⅸ、Ⅹ因子较对照组明显降低,Ⅷ因子呈显著升高,差异有统计学意义(P<0.05)。结论重症肝硬化患者血浆凝血因子和血小板参数变化显著,可及早发现重症肝硬化患者的凝血机制障碍,对评估肝硬化患者肝脏受损的严重程度有重要意义,有利于临床指导治疗和判断预后。
Objective To investigate the value of plasma coagulation factor and platelet parameters in the diagnosis of severe cirrhosis. Methods 45 cases of severe cirrhosis (Child-Pugh classification) and 45 healthy controls (control group) were randomly selected from the First Affiliated Hospital of Xinjiang Medical University. The platelet parameters and each coagulation index including platelet count (PLT), platelet pressure (PCT), mean platelet volume (MPV), mean platelet thickness (PDW), prothrombin time (PT) (TT), partial thromboplastin time (APTT), fibrinogen (FIB) and coagulation factors Ⅱ, Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ. Results The PLT in case group and control group were (43.67 ± 46.1) × 109 and (199.03 ± 33.2) × 109, respectively, and MPV were (14.56 ± 0.21) fl and (10.23 ± 1.30) % And (0.27 ± 0.11)%, PDW were (14.52 ± 2.13)% and (9.89 ± 1.01)% respectively. The above indexes in the case group were significantly lower than those in the control group (P <0.05). The PT, APTT and TT in the case group were significantly longer than those in the control group, in which the time difference △ PT> 3s and △ APTT> 10s between the case group and the control group. The fibrinogen of the case group was significantly lower than that of the control group. The cases Ⅱ, Ⅴ, Ⅶ, Ⅸ, Ⅹ factor were significantly lower than the control group, Ⅷ factor was significantly increased, the difference was statistically significant (P <0.05). Conclusion The changes of plasma coagulation factors and platelet parameters in patients with severe liver cirrhosis are significant. Early detection of coagulation disorders in patients with severe liver cirrhosis is of great significance in assessing the severity of liver damage in patients with cirrhosis, which is helpful for clinical guidance and prognosis.