摘要
目的观察肝移植受体移植前后抗凝血与纤溶指标的改变,探讨抗凝血酶AT-III(AT-III)及D-二聚体在重症肝病患者肝移植手术前后的变化及对预后的影响。方法采用日本Sysmex CA-1500型全自动凝血分析仪测定AT-III,挪威NycoCard ReaderII多功能金标定量检测仪测定血浆D-二聚体,观察65例重症肝病患者和35例肝移植患者移植前后的变化规律。结果急慢性肝炎组,肝硬化组,肝癌组以及其他肝病组(酒精性肝病,药物性肝衰等)患者AT-III均减少,且急慢性肝炎组、肝硬化组、肝癌组与参考值比较差异有统计学意义(P<0.01),其他肝病组与参考值比较差异有统计学意义(P<0.05)。血浆D-二聚体均增加,且各组与参考值比较有显著统计学意义(P<0.01)。肝移植术后较肝移植术前两项指标均发生改变,有显著统计学意义(P<0.01)。结论肝移植手术过程中,抗凝血功能降低,继发性纤溶亢进,手术后抗凝血功能逐渐恢复,继发性纤溶亢进亦得到有效缓解。
Objective To observe the changes of anticoagulant and fibrinolytic in the liver transplant patients before and after transplantation and discuss the effect of AT-III and plasma D-dimer on the patients with severe liver diseases before and after the liver transplant operation. Methods By the use of the Sysmex CA1500 in the detection of AT-III and the use of Nyco Card ReaderII in the detection of plasma D-dimer,the law of the changes was observed in the 65 patients with severe liver disease and the 35 liver transplanted patients before and after transplantation.Results AT-III was reduced in the groups of patients with acute and chronic hepatitis,cirrhosis,liver cancer and other liver diseases （alcoholic liver disease,drug-induced liver failure,etc.） Compared with AT-III of the control group,there was a conspicuous statistical significance in the groups of patients with acute and chronic hepatitis,cirrhosis,liver cancer（P0.01）; and there was a statistical significance in the group of patients with other liver diseases（P0.05）. Plasma D-dimer was increased. Compared with plasma D-dimer of the control group,there was a conspicuous statistical significance in the groups of patients with severe liver diseases（P0.01）. Compared with AT-III and plasma D-dimer of the patients before the liver transplant operation,there was a conspicuous statistical significance in the patients after the liver transplant operation（P0.01）.Conclusion Reduced anticoagulation function and hyperfibrinolysis appeared in the process of liver transplantation. After the operation,anticoagulation function was gradually resumed and hyperfibrinolysis was also effectively mitigated.
出处
《海南医学》
CAS
2010年第17期6-8,共3页
Hainan Medical Journal
关键词
重症肝病患者
肝移植
抗凝血
纤溶
Severe liver disease
Orthotropic liver transplantation
Anti-Coagulation function
Fibrinolysis
