摘要
目的探讨血浆D-二聚体、凝血指标在肝硬化及肝癌患者中的应用价值。方法选取2015年1月~2017年12月我院收治的50例肝硬化、50例肝癌患者与在我院行健康体检的50例健康志愿者,分别设为肝硬化组、肝癌组、对照组,所有患者及体检者均接受血液标本采集,对其血浆D-二聚体、凝血指标(凝血酶原时间(PT)、活化部分凝血活酶时间APTT)、凝血酶时间(TT))进行检测,比较三组的血浆D-二聚体及凝血指标。根据肝脏储备功能Child-Pugh分级标准,将肝硬化分为A级、B级、C级,比较不同Child-Pugh分级肝硬化的血浆D-二聚体及凝血指标。采用皮尔逊相关系数分析法,分析血浆D-二聚体、凝血指标与肝硬化及肝癌间的相关性。结果肝癌组的血浆D-二聚体水平高于肝硬化组、对照组,差异有统计学意义(P<0.05);肝硬化组的D-二聚体水平高于对照组,差异有统计学意义(P<0.05);肝癌组的PT、APTT、TT均低于肝硬化组、对照组,差异均有统计学意义(P<0.05);肝硬化组的PT、APTT、TT均低于对照组,差异有统计学意义(P<0.05)。Child-Pugh A级的血浆D-二聚体水平低于B级、C级,差异有统计学意义(P<0.05);Child-Pugh B级的血浆D-二聚体水平低于C级,差异有统计学意义(P<0.05);Child-Pugh A级的PT、APTT、TT均高于B级、C级,差异均有统计学意义(P<0.05);Child-Pugh B级的PT、APTT、TT均高于C级,差异有统计学意义(P<0.05)。血浆D-二聚体与肝硬化、肝癌均成正相关,而凝血指标与肝硬化、肝癌成负相关(P<0.05)。结论肝硬化、肝癌的血浆D-二聚体、凝血指标均异于常人,临床上可将血浆D-二聚体、凝血指标作为评价肝硬化、肝癌患者肝功能及凝血功能的重要指标。
Objective To explore the value of plasma D-dimer and coagulation index in patients with liver cirrhosis and liver cancer. Methods A total of 50 patients with cirrhosis, 50 patients with hepatocellular carcinoma and 50 healthy volunteers who underwent physical examination in our hospital from January 2015 to December 2017 were selected and set as liver cirrhosis group, liver cancer group and control group, all patients and the subjects were collected blood samples, the plasma D-dimer, coagulation parameters（prothrombin time, activated partial thromboplastin time,thrombin time） were detected, plasma D-dimer and coagulation index were compared between cirrhosis group, liver cancer group and control group. According to the Child-Pugh grading standard of liver reserve function, patients with cirrhosis were divided into A, B, C, and D-dimer and blood coagulation index in different Child-Pugh classification cirrhosis patients were compared. Pearson correlation coefficient analysis was used to analyze the correlation between plasma D-dimer, coagulation index and liver cirrhosis, liver cancer. Results The level of plasma D-dimer in the liver cancer group was higher than the liver cirrhosis group and the control group, the difference was statistically significant（P〈0.05）. The level of D-dimer in the liver cirrhosis group was higher than the control group, the difference was statistically significant（P〈0.05）. PT, APTT and the TT in the liver cancer group were lower than the liver cirrhosis group and the control group, the differences were statistically significant（P〈0.05）. PT, APTT and TT in the liver cirrhosis group were all lower than the control group, and the differences were statistically significant（P〈0.05）. The level of plasma D-dimer in Child-Pugh A patients was lower than grade B and C, and the differences were statistically significant（P〈0.05）. The level of D-dimer in Child-Pugh B patients was lower than grade C, and the difference was statistically significant（P〈0.05）. PT, APTT and TT in Child-Pugh A patients were higher than grade B and C, and the differences were statistically significant（P〈0.05）. PT, APTT and TT in Child-Pugh B patients were higher than grade C,and the differences were statistically significant（P〈0.05）. Plasma D-dimer and cirrhosis, liver cancer were positively correlated, and coagulation indicators and cirrhosis, liver cancer were negatively correlated（P〈0.05）. Conclusions Plasma D-dimer and coagulation index of patients with liver cirrhosis and liver cancer are different from those of normal people, plasma D-dimer and coagulation index can be used clinically to evaluate liver function and coagulation function in patients with liver cirrhosis and liver cancer index.
作者
陈晓敏
卢建新
CHEN Xiao-min;LU Jian-xin(Department of Oncology,People＇s Hospital of Shanwei City,Guangdong Province,Shanwei 516600,China)
出处
《中国当代医药》
2018年第21期46-48,共3页
China Modern Medicine
关键词
肝硬化
肝癌
D-二聚体
凝血功能
Cirrhosis
Liver cancer
D-dimer
Coagulation function
