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目的:通过凝血实验室指标与临床病症的紧密结合,对肝硬化患者的诊断治疗和病情监测进行研究和分析。方法:对临床确诊的12例肝硬化代偿组(LC-1)、67例肝硬化失代偿组(LC-2)和健康对照组(N)进行PT、PA、APTT、FIB、V、VⅡ、VⅢ、DD及PLT的测定和分析。结果:1.肝硬化失代偿患者(LC-2)PT、PA、APTT、FIB、V、VⅡ、DD及PLT水平与N组比较均存在显著性差异(P<0.001);LC-2组与LC-1组比较,PT、PA、APTT、V、VⅡ、FIB水平存在显著性差异(P<0.01);2.肝硬化失代偿患者PA与VⅡ相关性最高(r=0.66);3.DD、V和VⅡ在肝硬化有腹水组和无腹水组之间均具有极显著性差异(P<0.001)。结论:1.DD、PT、PA、APTT、FIB、V、VⅡ、PLT水平对LC-2具有很好的诊断价值。2.PT、PA、APTT、V、VⅡ、FIB对LC-1与LC-2具有一定的鉴别价值。3.DD、V和VⅡ对肝硬化有腹水组和无腹水组具有一定的预测价值。4.DD、V、VⅡ和APTT对肝硬化的早期诊断、分期和预后具有重要的价值,应该加强其在临床的应用。
Objective: To study and analyze the diagnosis, treatment and condition monitoring of patients with cirrhosis through the close combination of coagulation laboratory indexes and clinical symptoms. Methods: Twelve cases of LC-1, 67 cases of decompensated liver cirrhosis (LC-2) and healthy controls (N) were enrolled in this study. PT, PA, APTT, FIB, V Ⅱ, V Ⅲ, DD and PLT determination and analysis. The levels of PT, PA, APTT, FIB, V, VⅡ, DD and PLT in LC-2 patients were significantly different from those in N group (P <0.001) Compared with LC-1 group, the levels of PT, PA, APTT, V, VII and FIB were significantly different (P <0.01); 2. The correlation between PA and VII was the highest in patients with decompensated liver cirrhosis .DD, V and VⅡhad significant difference between cirrhotic group with ascites and without ascites group (P <0.001). Conclusion: 1.DD, PT, PA, APTT, FIB, V, VⅡ, PLT levels have a good diagnostic value of LC-2. PT, PA, APTT, V, VII, FIB have certain discriminative value for LC-1 and LC-2. 3.DD, V and V Ⅱ have certain predictive value for cirrhotic patients with ascites group and without ascites group. 4.DD, V, V Ⅱ and APTT have important value in the early diagnosis, staging and prognosis of cirrhosis, and should be strengthened in clinical application.