摘要
目的:探讨凝血指标在肝纤维化进展中的作用。方法:选取2017年3月-2020年2月本院收治的276例慢性乙肝患者的临床资料进行回顾性分析,根据有无肝硬化将其分为肝硬化组(n=62)与单纯慢乙肝组(n=214)。另选取30例同期于本院进行健康体检者作为健康对照组。比较三组入院时的凝血酶原时间(PT)、凝血酶原活动度(PTA)、凝血酶时间(TT)、部分活化凝血酶时间(APTT)与纤维蛋白原(FIB),分析上述指标与慢性乙肝患者进展为肝硬化的相关性及预测价值。结果:肝硬化组的PT、TT与APTT均高于健康对照组及单纯慢乙肝组,而PTA与FIB均低于健康对照组及单纯慢乙肝组(P<0.05)。慢性乙肝患者进展为肝硬化与PT、TT与APTT呈正相关,而与PTA及FIB呈负相关(P<0.05)。ROC曲线分析显示,PT、FIB、TT、PTA、APTT联合预测曲线下面积(AUC)最高,对预测慢性乙肝患者进展为肝硬化的敏感度为0.806,特异度为0.911。结论:随着慢性乙肝患者肝纤维化进展至肝硬化,其凝血功能下降,凝血指标PT、FIB、TT、PTA与APTT联合检测对于慢性乙肝患者发生肝硬化的预测有一定应用价值。
Objective:To explore the role of coagulation index in the progress of liver fibrosis.Method:Clinical data of 276 patients with chronic hepatitis B admitted to our hospital from March 2017 to February 2020 were retrospectively analyzed,and they were divided into cirrhosis group(n=62)and chronic hepatitis B group(n=214)according to the presence or absence of cirrhosis.Another 30 healthy subjects underwent physical examination in the same period were selected as the healthy control group.The prothrombin time(PT),prothrombin activity(PTA),thrombin time(TT),partially activated thrombin time(APTT)and fibrinogen(FIB)at admission in the three groups were compared,and the correlation and predictive value of the above indexes with the progression to cirrhosis in patients with chronic hepatitis B were analyzed.Result:The PT,TT and APTT in the cirrhosis group were higher than those in healthy control group and simple chronic hepatitis B group,while the PTA and FIB were lower than those in the healthy control group and the chronic hepatitis B group(P<0.05).The progression of cirrhosis in patients with chronic hepatitis B were positively correlated with PT,TT and APTT,but negatively correlated with PTA and FIB(P<0.05).ROC curve analysis showed that the combined prediction area under the curve(AUC)of PT,FIB,TT,PTA and APTT was the highest,with a sensitivity of 0.806 and a specificity of 0.911 for predicting the progression of cirrhosis in patients with chronic hepatitis B.Conclusion:With the progression of liver fibrosis in patients with chronic hepatitis B to cirrhosis,the coagulation function decreased.The combined detection of PT,FIB,TT,PTA and APTT has a certain application value for the prediction of liver cirrhosis in patients with chronic hepatitis B.
作者
区永光
夏汝年
梁灵
OU Yongguang;XIA Runian;LIANG Ling(Zhaoqing Hospital of Traditional Chinese Medicine,Zhaoqing 526020,China;不详)
出处
《中国医学创新》
CAS
2021年第7期130-133,共4页
Medical Innovation of China
关键词
凝血指标
慢性乙型肝炎
肝纤维化
肝硬化
Coagulation index
Chronic hepatitis B
Liver fibrosis
Cirrhosis
