青海地区急性上消化道出血患者外周血中DD、PLT、PT、APTT的水平变化及临床意义

发布时间：2018-01-21 11:31

本文关键词： 急性上消化道出血 D-二聚体血小板凝血酶原时间部分活化凝血活酶时间　出处：《青海大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过测定青海地区急性上消化道出血患者外周血中D-二聚体(DD)、血小板(PLT)、凝血酶原时间(PT)及活化部分凝血活酶时间(APTT)的水平变化,试图研究这四种实验室指标的水平变化与不同病因引起的急性上消化道出血的联系,为临床医生初步判断急性上消化道出血病因提供一定的参考依据。方法:1.收集2015年11月至2016年11月在青海大学附属医院住院确诊的急性上消化道出血患者160例。2.收集患者入院初接受治疗前的相关化验指标:DD、PLT、PT、APTT的测定值。3.资料分组:肝病所致急性上消化道出血患者52例(乙肝组42例,丙肝组10例),胃癌所致急性上消化道出血患者37例,溃疡所致急性上消化道出血患者71例(GU32例,DU39例)4.应用全自动血凝仪测定DD、PT、APTT的水平,采用血液细胞分析仪检测PLT。结果:1.DD:各组的DD比较,差异均有统计学意义(P0.001),肝病组比胃癌组、溃疡组的DD水平有明显升高,胃癌组比溃疡组DD升高;2.PLT比较:肝病组其水平降低明显,胃癌组和溃疡组PLT水平无明显的差异(P0.05)。3.PT比较:肝病组PT的测定值升高明显,胃癌组和溃疡组PT无明显的差异(P0.05)。4.APTT比较:肝病组APPT的测定值升高明显,胃癌组和溃疡组APPT的检测值无明显的差异(P0.05)。5.DD、PLT、PT、APTT在肝病组中的乙肝组和丙肝组比较结果显示无明显差异(P0.05);DD在溃疡组中DU组和GU组比较(P0.05)差异有统计学意义,PLT、PT、APTT在GU组和DU组间比较无明显差异(P0.05)。结论:1.青海地区在引起急性上消化道出血的三种疾病中,溃疡所占比重最高,肝病次之,胃癌最低。2.青海地区在不同病因所致AUGIB的病人外周血中DD、PLT、PT、APTT的水平不同。3.肝病并AUGIB患者外周血DD、PT、APTT水平高于胃癌并AUGIB和溃疡并AUGIB的患者,PLT水平明显低于胃癌并AUGIB和溃疡并AUGIB的患者。胃癌并AUGIB患者DD水平高于溃疡并AUGIB;胃癌并AUGIB患者外周血PLT、PT、APTT水平和溃疡并AUGIB组无明显差异。4.肝病并AUGIB患者中乙肝组与丙肝组患者外周血DD、PLT、PT、APTT无明显差异;溃疡并AUGIB患者中GU组患者DD水平稍高于DU组,PLT、PT、APTT水平无明显差异。
[Abstract]:Objective: to determine the level of D-dimer in peripheral blood of patients with acute upper gastrointestinal hemorrhage in Qinghai area. The changes of prothrombin time (PTT) and activated partial thromboplastin time (APTT) were studied to study the relationship between the changes of these four laboratory indexes and acute upper gastrointestinal bleeding caused by different etiology. To provide a reference for clinicians to judge the etiology of acute upper gastrointestinal hemorrhage. Methods:. 1. To collect 160 cases of acute upper gastrointestinal bleeding diagnosed from November 2015 to November 2016 in the affiliated Hospital of Qinghai University. Marks:. DD. Data group: 52 patients with acute upper gastrointestinal hemorrhage caused by liver disease (hepatitis B 42 cases, hepatitis C 10 cases). There were 37 patients with acute upper gastrointestinal hemorrhage caused by gastric cancer and 71 patients with acute upper gastrointestinal hemorrhage caused by ulcer. The level of APTT was detected by blood cell analyzer. Results: 1. The DD of each group was significantly higher than that of gastric cancer group (P 0.001), and that of liver disease group was higher than that of gastric cancer group. DD level in ulcer group was significantly higher than that in gastric cancer group. 2. Comparison of PLT: the level of PLT decreased significantly in liver disease group, but there was no significant difference between gastric cancer group and ulcer group. 3. PT comparison: PT in liver disease group increased significantly. There was no significant difference in PT between gastric cancer group and ulcer group (P 0.05). 4. Comparison of APTT: the value of APPT in liver disease group was higher than that in control group. There was no significant difference in the detection value of APPT between gastric cancer group and ulcer group. The comparison of APTT in hepatitis B group and hepatitis C group showed that there was no significant difference between hepatitis B group and hepatitis C group (P 0.05). DD in the ulcer group DU group and gu group compared with P0.05) there was a significant difference between DU group and gu group (P 0.05). There was no significant difference in APTT between gu group and DU group. Conclusion 1. Among the three diseases causing acute upper gastrointestinal hemorrhage in Qinghai area, ulcers account for the highest proportion, followed by liver diseases. The level of APTT in peripheral blood of patients with AUGIB caused by different etiology in Qinghai area is different. The level of APTT in patients with liver disease and AUGIB is different. DD in peripheral blood of patients with liver disease and AUGIB is different. The level of PTT APTT in gastric cancer patients with AUGIB and ulcer with AUGIB was higher than that in patients with gastric cancer and ulcer with AUGIB. The level of PLT was significantly lower in patients with gastric cancer with AUGIB and ulcers with AUGIB. The DD level of patients with gastric cancer with AUGIB was higher than that with ulcer with AUGIBB. There was no significant difference in APTT levels in peripheral blood between patients with gastric cancer and AUGIB and those with AUGIB and ulcer. 4. DD in peripheral blood of patients with hepatitis B and hepatitis C in patients with liver disease and AUGIB. There was no significant difference in APTT between PLT and PTT. There was no significant difference in DD level in patients with ulcer and AUGIB compared with that in DU group.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R573.2

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