肝硬化患者凝血及抗凝血指标变化.docVIP

肝硬化患者凝血及抗凝血指标变化 　　[摘要]目的：了解肝硬化患者凝血、抗凝血功能变化。方法：采用日本SysmexCA-1500血液凝聚仪测定凝血酶原时间（ＰＴ）、部分凝血活酶时间（ＡＰＴＴ）、凝血酶时间（ＴＴ）、纤维蛋白原含量（Ｆｇ），火箭电泳法测定抗凝血酶Ⅲ抗原含量（ＡＴ－ⅢＡｇ），凝血酶凝胶空斑法测定抗凝血酶Ⅲ活性（ＡＴ－ⅢＡ）。结果：肝硬化患者凝血指标即凝血酶原时间、凝血酶时间、部分凝血活酶时间明显延长，纤维蛋白原含量减少；抗凝血指标中抗凝血酶Ⅲ活性及抗凝血酶Ⅲ抗原含量均降低，且随着肝功能从A→B→C(Child－Pugh)的变化，上述变化趋势愈加明显。结论：肝硬化患者凝血及抗凝血功能明显降低，且随着肝功能的降低，这些指标的变化更加显著。因此观察这些指标的变化，有助于评估肝功能损害的变化及预后，预测出血与血栓发生的可能性。 　　[关键词]肝硬化；凝血功能；??凝血功能 　　[中图分类号]R446 [文献标识码]B [文章编号]1673-7210（2007）10（b）-096-02 　　 　　Detection of the functions of the blood coagulation and anticoagulation in patients with liver cirrhosis 　　WU Long-qi1,MA Xiao-bo2,SHAO Cui-qing1 　　（1.Shandong Traffic Hospital,Jinan250031,China；2.Shandong Traditional Chinese Medicine Hospital,Jinan250012,China） 　　[Abstract]Objective: To observe the changes of functions of blood coagulation and anticoagulation in patients with liver cirrhosis and their relations with the grade of the Child-Pugh liver function.Methods: According to the Child－Pugh criteria,we divided the patients into three groups－A,B,C. Prothrombin time (PT),thrombin time（TT）,activated partial thromboplastin time (APTT) , and fibrinogen(Fib)were measured with automatic coagulator (Sysmex CA-1500,Japan),thrombin-gelatum plapue were used to test antithrombin Ⅲ antigen (AT－ⅢAg) and antithrombin Ⅲ activity (AT－ⅢA) respectively.Results:PT，TT and APTT in patients with liver cirrhosis were significantly longer than those in the control group，AT－ⅢAgandAT－ⅢA in patients with liver cirrhosis were significantly lower than in the control.Above of these changes were more obvious as the liver function changes from A→B→C.But the change of Fib only could be seen in grade B and C.Conclusion: The functions of blood coagulation and anticoagulantion in patients with cirrhosis are lower,and as the liver function deteriorates gradually these changes become more obvious,so these markers are useful to evaluate liver damage,predict bleeding or thrombosis,estimate prognosis. 　　[Key words]Liver cirrhosis；Coagulant functi