摘要
[目的]探究血清炎症、凝血及免疫因子在肝硬化合并肝功能衰竭患者中的变化及临床意义。[方法]选取2016-03-2018-05期间在本院接受治疗的61例肝硬化并肝衰竭患者作为A组,72例慢性乙肝患者作为B组,58例慢性乙肝肝硬化患者作为C组,同期体检健康者95例作为D组。比较分析各组的炎症因子、凝血及免疫指标的变化。[结果]各组降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)、凝血活酶时间(APTT)、凝血酶原活动度(PTA)、D二聚体(DD)、免疫球蛋白-A(IgA)、免疫球蛋白-G(IgG)及免疫球蛋白-M(IgM)水平比较均差异有统计学意义(P<0.05)。与D组相比,A组、B组及C组APTT、PTA、DD、IgA、IgG水平均显著增加(P<0.05),而PTA水平均显著降低(P<0.05);与B组相比,A组及C组APTT、PTA、DD、IgA、IgG水平均显著增加(P<0.05),而PTA水平均显著降低(P<0.05);与C组相比,A组APTT、PTA、DD、IgA、IgG水平均显著增加(P<0.05),而PTA水平均显著降低(P<0.05)。A组中Child-Pugh分级为C级的患者PCT、CRP、WBC、APTT、PTA、DD、IgA、IgG及IgM水平显著高于A级及B级患者(P<0.05),PTA水平均显著低于A级及B级(P<0.05)。[结论]肝硬化并肝衰竭患者炎症反应较为剧烈,抗凝能力较强,免疫球蛋白呈高表达状态,上述指标均可反映患者肝功能受损程度,通过监测该类指标的变化对肝病患者病情判断、预防治疗及预后评估具有重要临床意义。
[Objective]To investigate the changes and clinical significance of serum inflammatory,coagulation and immune factors in patients with liver cirrhosis complicated with liver failure.[Methods]From March 2016 to May 2018,61 patients with cirrhosis and liver failure were selected as group A,72 patients with chronic hepatitis B as group B,and 95 healthy people as group C,58 patients with chronic hepatitis B liver cirrhosis were treated as group D.The levels of inflammatory factors,coagulation and immune indexes in three groups were compared and analyzed.[Results]There were significant differences in levels of PCT,CRP,WBC,APTT,PTA,DD,IgA,IgG and IgM among the four groups(P<0.05).Compared with group C,the levels of APTT,PTA,DD,IgA and IgG in group A,group B and group D increased significantly(P<0.05),while the levels of PTA decreased significantly(P<0.05).Compared with group B,the levels of APTT,PTA,DD,IgA and IgG in group A and group D increased significantly(P<0.05),while the levels of PTA decreased significantly(P<0.05).Compared with group D,the levels of APTT,PTA,DD,IgA and IgG in group A increased significantly(P<0.05),while the levels of PTA decreased significantly(P<0.05).The levels of PCT,CRP,WBC,APTT,PTA,DD,IgA,IgG and IgM in patients with Child-Pugh grade C were significantly higher than those in grade A and B(P<0.05),and the levels of PTA were significantly lower than those in grade A and B(P<0.05).[Conclusions]Patients with cirrhosis and liver failure have severe inflammatory reaction,strong anticoagulant ability and high expression of immunoglobulin.The above indicators can reflect the degree of liver function damage.Monitoring the changes of these indicators has important clinical significance in judging the condition,prevention,treatment and prognosis of patients with liver diseases.
作者
张燕
扎西吉
咸育婷
魏连存
ZHANG Yan;Zhaxiji;XIAN Yu-ting;WEI Lian-cun(Clinical Laboratory,the Fourth People's Hospital of Qinghai Province,810000 Xining,Qinghai,China)
出处
《临床消化病杂志》
2019年第6期379-383,共5页
Chinese Journal of Clinical Gastroenterology
关键词
炎症
凝血
免疫因子
肝硬化合并肝功能衰竭
inflammation
coagulation
immunofactors
cirrhosis with liver failure
clinical significance
