血浆纤维蛋白原及胆道梗阻关系初步探究.docVIP

血浆纤维蛋白原及胆道梗阻关系初步探究[摘要] 目的 对血浆纤维蛋白原（fibrinogen，FIB）与胆道梗阻的关系进行初步探讨。方法 113例胆道疾病患者分成四组：A胆道结石组、B胆道结石＋胆道感染组、C胆道结石＋胆道感染＋胆道梗阻组、D壶腹癌＋胆道梗阻组。比较四组间FIB的差异，分析 C组中FIB升高者与正常者间的生化及凝血功能指标的差异。 结果A、B组间与 C、D组间FIB差异无统计学意义（P＜0.05）。C、D组与A、B组间FIB差异有统计学意义（P＜0.05）。C组中FIB≤4g/L者与＞4g/L者组间胆红素值差异有统计学意义（P＜0.05）。 结论 胆道梗阻是导致血浆FIB升高的原因，阻塞性黄疸的患者若Fib＜4g/L可能表示肝功能损害严重。 [关键词] 纤维蛋白原；胆道梗阻；胆道结石；阻塞性黄疸；凝血 [中图分类号] R575[文献标识码] B[文章编号] 1673-9701（2011）20-64-03 Relationship between the Plasma Fibrinogen and Biliary Tract Obstruction ZHU ZhengheTAN YihongXIAO YugenDU GuonengLIU Jianwen Department of General Surgery，Foshan City Nanhai DistrictPeoples Hospital， Foshan 528200，China [Abstract] Objective To investigate the relationship between plasma fibrinogen and biliary tract obstruction. Methods 113 cases of patients with bile duct disease were divided into four groups： Group A，biliary tract stones；Group B，biliary tract stones with biliary tract infection；Group C， biliary tract stones with biliary tract infection and biliary tract obstruction；Group D，ampullary carcinomas with biliary tract obstruction. The differences of fibrinogen levels among four groups were analyzed. According to the levels of fibrinogen，Group C was divided into normal group andabnormal group. Indexes of biochemical function and blood coagulation were compared. Results There were signicant differences between groups C，D and groups A，B（P＜0.05）. In group C， statistical differences in bilirubin were observed between the high fibrinogen group（＞4g/L） and low fibrinogen groups（≤4g/L）. Conclusion Biliary tract obstruction can lead to increasing of plasma fibrinogens. The fibrinogen level lower than 4g/L in patients with obstructive jaundice is indicating serious damage of liver. [Key words] Fibrinogen；Biliary tract obstruction；Bile duct stones；Jaundice obstructive；Blood coagulation 血浆纤维蛋白原（fibrinogen）即凝血因子Ⅰ，也是一种急性反应蛋白，主要在肝脏合成，在恶性肿瘤、损伤、炎症、感染、糖尿病、肾病及肝脏疾病时均升高。但目前关于胆道梗阻与纤维蛋白原的关系，国内外均未见文献报道。笔者回顾性分析了我院2006年3月～2010年6月收治的各种胆道疾患患者的临床资料和血液学