摘要
目的:研究病毒性肝炎患者凝血纤溶状态的改变,探讨各指标对于肝炎的提示作用。方法:对正常人和各类肝炎患者检测凝血因子、AT、PC、PS等29项指标以反映凝血抗凝系统状态;检测t-PA、PL、PAI、PLG、FDP、α_2PI、DD、PAP等10项指标以反映纤溶系统状态。用SAS软件进行统计分析。结果:除急性肝炎患者因子Ⅱ:C、Ⅸ:C、Ⅹ:C、Ⅻ:C、Fg、PAP:Ag、DD不改变外,其余各类肝炎患者各指标与正常人比较均有显著差异;各指标均与肝炎的严重程度相关;AT/α_2PI比率均<1;α_2PI低于正常人的40％时,病人可出现出血;AT<20％预后不佳;vWWF:Ag/Ⅷ:C比值升高提示患者有并发DIC的可能。结论:肝炎患者抗凝活性下降,存在着纤溶;各指标可用于评价肝脏损伤,防治出血,判断预后。
Objective: To study changes of coagulation-fibrinolytic system in viral hepatitis patients, explore the application of coagulation-fibrinolytic system markers in viral hepatitis. Methods:For controls and viral hepatitis patients, the determination of 29 indicators was performed to analyze the coagulation-anticoagulant system state, the determination of 10 indicators such as t-PA, PL, PAI, PLG, FDP,α2PI, PAP, D-dimmer was performed to analyze the fibrinolytic system state. The results were analyzed with SAS system software. Results: A significant change of all indicators was observed in all kinds of viral hepatitis except that no significant difference of Ⅱ:C,Ⅸ:C, Ⅹ:C, Ⅻ:C, Fbg, PAP: Ag, D-dimmer was observed in acute hapatitis and controls. The levels of them were parallel with the severity of the disease. The ratio of AT and α2PI was less than 1. Patients whose α2PI was lower than 40% would show clinical bleeding. Patients whose AT was lower than 20% would predict a bad prognosis. The improvement of vWF: Ag/Ⅷ:C ratio could indicate the possibility of DIC. Conclusion: There are decreased anticoagulant activity and fibrinolytic state in viral hepatitis patients. These markers are useful to evaluate liver damage, predict bleeding, estimate prognosis.
出处
《血栓与止血学》
2001年第2期62-66,共5页
Chinese Journal of Thrombosis and Hemostasis
基金
部分受胡应洲基金
关键词
病毒性肝炎
凝血
纤溶系统
Viral hepatitis Coagulation Fribinolysis
