凝血指标和血小板参数在肝病进展中的变化规律

发布时间：2019-03-28 06:16

【摘要】：目的包括血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板容积(PCT),探讨常见凝血指标和血小板参数在慢性病毒性肝炎、肝硬化及肝衰竭患者中的变化规律。方法选取2015年1月至2016年6月于该院治疗的肝病患者共120例,分为慢性病毒性肝炎组(46例)、肝硬化组(Child-Pugh A、B、C级)(44例)、肝衰竭组(30例)及同期健康体检者30例为健康对照组。检测所有受试者的凝血指标包括凝血酶原时间(PT)、凝血酶原活动度(PTA)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fg)、D-二聚体(D-D),以及血小板参数(PLT、MPV、PDW、PCT)。结果除TT、Fg和D-D在健康对照组与慢性病毒性肝炎组差异无统计学意义(P0.05),慢性病毒性肝炎组、肝硬化组(Child-Pugh A、B、C级)和肝衰竭组的PT、APTT和TT逐渐延长,PTA和Fg下降,D-D值增加,组间两两比较差异具有统计学意义(P0.05)。慢性病毒性肝炎组、肝硬化组(Child-Pugh A、B、C级)和肝衰竭组的PLT值逐渐下降,而MPV、PDW值逐渐增高,差异有统计学意义(P0.05),肝硬化组和肝衰竭组的PCT值低于慢性病毒性肝炎组(P0.05)。结论凝血指标和血小板参数在慢性肝病进展的不同时期发生规律性改变,为临床诊治及预后判断提供一定的参考。
[Abstract]:Objective to investigate the common coagulation indexes and platelet parameters in chronic viral hepatitis including platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet volume (PCT),. Changes in liver cirrhosis and liver failure. Methods from January 2015 to June 2016, a total of 120 patients with liver disease were divided into chronic viral hepatitis group (46 cases) and cirrhosis group (Child-Pugh A, B, C grade) (44 cases), and the patients were divided into two groups: chronic viral hepatitis group (n = 46) and cirrhosis group (n = 44). Liver failure group (n = 30) and healthy physical examination group (n = 30) were healthy control group. The coagulation indexes including prothrombin time (PT), prothrombin activity (PTA), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fg), were measured in all subjects. D-dimer (D-D) and platelet parameter (PLT,MPV,PDW,PCT). Results there was no significant difference between the control group and the chronic viral hepatitis group except TT,Fg and D D (P0.05). The PT, of chronic viral hepatitis group, cirrhosis group (Child-Pugh A, B, C) and liver failure group were not significantly different (P0.05). APTT and TT were prolonged gradually, PTA and Fg were decreased, D D was increased, the difference between two groups was statistically significant (P0.05). The PLT value of chronic viral hepatitis group, cirrhosis group (Child-Pugh A, B, grade C) and liver failure group decreased gradually, while the MPV, PDW value gradually increased, the difference was statistically significant (P0.05). The value of PCT in cirrhosis group and liver failure group was lower than that in chronic viral hepatitis group (P0.05). Conclusion there are regular changes in coagulation index and platelet parameter in different stages of the progression of chronic liver disease, which can provide some reference for clinical diagnosis and treatment and prognosis judgement.
【作者单位】：湖北省洪湖市人民医院检验科;
【分类号】：R575;R446.11

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