摘要
目的探讨凝血因子和纤溶指标在病毒性肝炎和妊娠肝炎中的变化和意义.方法将142例病毒性肝炎分为急性肝炎、慢性肝炎轻度、慢性肝炎中/重度、肝硬化和重症肝炎五组,妊娠肝炎35例,同步检测凝血因子V活性(FV:C)、凝血因子Ⅶ活性(FⅦ:C)、凝血因子X活性(FX:C)、纤溶酶活性(PL:A)、组织纤溶酶原激活剂活性(t-PA:A)、纤溶酶原激活物抑制剂活性(PAI:A)、D-二聚体(D-D)和纤维蛋白降解产物(FDP)八项指标,并分别与90例正常对照组和32例正常晚孕组测定结果相比较.结果与正常对照组比较,急性肝炎FV:C增高(P<0.05),其余各类肝炎FV:C、Ⅶ:C、FX:C的血浆水平均有不同程度的降低(P<0.05～<0.01);妊娠肝炎组的凝血因子水平高于正常对照组,但低于正常晚孕组.除慢性肝炎轻度组D-D外,各型肝炎其余指标与正常对照组比较,差异均有统计学意义(P<0.05～<0.01),PAI:A 均显著下降,PL:A、t-PA:A、D-D、FDP均显著升高,它们的改变与肝脏损害严重程度呈一致的趋势.妊娠肝炎组与正常晚孕组比较,纤溶指标差异均有统计学意义(P<0.05～<0.01).结论病毒性肝炎和妊娠肝炎患者凝血因子和纤溶指标测定将有助判断肝炎严重程度,防治出血、推测预后和观察疗效.
Objective To explore the clinical significance of coagulation factor and fibrinolytic indexes in viral hepatitis and pregnant hepatitis. Methods 142 inpatients with viral hepatitis classified into five subgroups （acute hepatitis; mild chronic hepatitis; chronic moderate/severe hepatitis; cirrhosis and severe hepatitis）,and 35 cases of pregnant hepatitis were measured eight indexes of FV：C.FV Ⅱ ： C. FX ： C, PL ： A. t-PA ： A, PAI： A. D-D和 FDP respectively and the results were compared with that of 90 cases from normal control group and 32 cases of normal pregnant women. Results Compared with control, plasma FV： C increased evidently in acute hepatitis （P〈0.05） ; plasma FV： C, FVⅡ ： C, FX： C decreased with different extent in the other types of hepatitis （P〈0.05-〈0.01）. Plasma levels of coagulating factors in pregnant hepatitis were higher than those in control, but lower than those in normal pregnancy. Compared with control, the coagulating indexes but D-D in hepatitis but mild chronic hepatitis had significantly difference （P〈0.05 - 〈0.01 ）; PAI： A decreased evidently, and PL： A, t-PA： A, D-D, FDP increased evidently. The changes of coagulating indexes were related with the extent of liver lesion. Fibrinolytic indexes had significantly difference （ P〈0.05 - 〈0.01 ） between pregnant hepatitis and normal pregnancy. Conclusions Coagulation factor and fibrinolytic indexes could be used to evaluate the severity of viral hepatitis and pregnant hepatitis, prevent bleeding and predict the prognosis and efficacy of treatment.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2005年第3期191-194,共4页
Chinese Journal of Infectious Diseases
