晚期血吸虫病肝硬化和乙型肝炎肝硬化患者凝血相关参数比较分析

发布时间：2018-02-28 09:14

本文关键词： 晚期血吸虫病乙型肝炎肝硬化凝血功能血小板　出处：《中国血吸虫病防治杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的比较、分析晚期血吸虫病肝硬化和乙型肝炎肝硬化患者凝血功能相关参数在不同肝功能分级下的差异,为临床病情及预后的判断提供进一步的指导依据。方法选择荆州市中心医院2014年1月-2016年6月期间住院的晚期血吸虫病肝硬化患者63例、乙型肝炎肝硬化患者80例分别作为血吸虫肝硬化组和乙肝肝硬化组;选择同期因胃病住院并排除患其他可能影响凝血功能疾病的患者96例作为对照组,检测并比较3组凝血相关参数值,以及不同Child-Pugh分级下晚期血吸虫病肝硬化和乙型肝炎肝硬化患者相关参数值。结果 3组凝血酶原时间(PT)、国际标准化比率(INR)、纤维蛋白原(Fib)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、血小板(PLT)水平差异均有统计学意义(F=84.512、81.672、37.612、104.475、52.497、102.233,P均0.05)。两两比较显示,血吸虫病和乙肝肝硬化患者的PT、INR、TT、APTT均较对照组明显延长,PLT均明显减少,差异均有统计学意义(P均0.05)。与血吸虫病肝硬化组相比,乙肝肝硬化患者PT、INR、TT、APTT时间均明显延长,Fib及PLT明显下降,差异均有统计学意义(P均0.05)。肝功能分级为Child-Pugh A级时,乙肝肝硬化患者PLT减少程度较重;但当肝功能分级为Child-Pugh B、C级时,2组患者PLT计数差异无统计学意义(P均0.05)。各分级下,乙肝肝硬化组TT、APTT均较血吸虫病肝硬化组延长,且Fib水平均明显下降。而乙肝肝硬化组PT、INR值仅在肝功能为Child-Pugh A、B级时较血吸虫病肝硬化组延长;在肝功能为C级时,两组差异无统计学意义(P均0.05)。结论晚期血吸虫病肝硬化患者和乙型肝炎肝硬化患者凝血功能损害程度存在差异。在肝功能受损程度较轻时,后者凝血功能下降更明显;肝功能受损严重时,后者内源性凝血途径的影响更为明显,外源性凝血途径的影响及PLT减少在两类患者中差异不大。
[Abstract]:Objective to compare and analyze the difference of coagulation function related parameters in patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis under different liver function grades. Methods 63 patients with advanced schistosomiasis cirrhosis hospitalized in Jingzhou Central Hospital from January 2014 to June 2016 were selected. Eighty patients with hepatitis B cirrhosis were treated as schistosomiasis cirrhosis group and hepatitis B cirrhosis group respectively. 96 patients who were hospitalized because of gastric diseases and excluded from other diseases that may affect coagulation function were selected as control group. The parameters related to coagulation were detected and compared among the three groups. Results in three groups of patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis, the prothrombin time, the international standard ratio of Child-Pugh, fibrinogen, thrombin time and activated partial coagulation were obtained. There were significant differences in the levels of APTTT and PLT between the two groups (P < 0.05). There were significant differences in the levels of APTTT and PLT (84.512), 81.672 (37.612), 104.475 (52.497) and 102.233C (P < 0.05), respectively. Compared with the patients with schistosomiasis and cirrhosis of hepatitis B, the time of PLT and PLT in the patients with hepatitis B cirrhosis decreased significantly compared with those in the patients with schistosomiasis and liver cirrhosis, and the difference was statistically significant (P < 0.05), compared with the patients with schistosomiasis cirrhosis, the time of PTT in patients with hepatitis B cirrhosis was significantly longer than that in patients with cirrhosis of hepatitis B (P < 0.05). The difference was statistically significant (P < 0.05). When the liver function grade was Child-Pugh A, the decrease of PLT was more serious, but when the liver function grade was Child-Pugh C, there was no significant difference in PLT count between the two groups (P < 0.05). The Fib levels in liver cirrhosis group were longer than those in schistosomiasis cirrhosis group, and the Fib level in hepatitis B cirrhosis group was significantly lower than that in schistosomiasis cirrhosis group, and the Fib level in liver cirrhosis group was longer than that in schistosomiasis cirrhosis group only when the liver function was Child-Pugh Agna B grade, and when liver function was C grade, there was no significant difference between liver function group and liver cirrhosis group. There was no significant difference between the two groups (P < 0.05). Conclusion there is a difference in the degree of coagulation function damage between patients with advanced schistosomiasis cirrhosis and hepatitis B cirrhosis. When liver function was seriously damaged, the effect of endogenous coagulation pathway was more obvious. The effect of exogenous coagulation pathway and the decrease of PLT were not significantly different between the two groups of patients.
【作者单位】：长江大学第二临床医学院荆州市中心医院;长江大学医学院;
【分类号】：R532.21;R512.62;R575.2

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