血凝四项在不同程度弥散性血管内凝血中的对比研究

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摘要目的通过对弥散性血管内凝血（DIC）不同病程时期凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、纤维蛋白原（FIB）含量和凝血酶时间（TT）等指标的检测，探讨DIC 发病程度与血凝四项水平的关系，评估血凝四项应用于DIC 临床诊断的价值。方法选取2018年3月～2019年4月我院收治的90例存在已知DIC 相关的基础疾病患者，根据前期诊断将其分为高凝组、低凝组以及纤溶组，每组各30例；另随机选取同期体检的30例健康志愿者作为对照组，分别测定各组的血凝四项水平，并分析血凝四项与DIC 病程发展的相关性。结果高凝组、低溶组及纤溶组的PT、APTT 均长于对照组，差异有统计学意义（P＜0.05）；低溶组与纤溶组的TT 长于对照组，FIB低于对照组，差异有统计学意义（P＜0.05）；高凝组与对照组的TT、FIB 含量比较，差异无统计学意义（P＞0.05）。低溶组的APTT 长于高凝组，FIB 含量低于高凝组，差异有统计学意义（P＜0.05）；纤溶组的PT、APTT、TT 均长于高凝组，FIB 含量低于高凝组，差异有统计学意义（P＜0.05）；纤溶组的PT、APTT、TT 均长于低溶组，FIB 含量低于低溶组，差异有统计学意义（P＜0.05）。直线相关性分析显示，PT、APTT 与DIC 病程发展成正相关（r=0.81、0.77，P＜0.05）；FIB 与DIC 病程发展成负相关（r=-0.72，P＜0.05）；TT 与DIC 病程发展无相关性（P＞0.05）。结论血凝四项指标在DIC 不同病程时期的差异显著，各指标早期检测分析有助于早期DIC的临床诊断及对DIC 病程发展时期的预测。

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	井峰

关键词 ：弥散性血管内凝血, 血凝四项, 凝血酶原时间, 活化部分凝血酶原时间, 纤维蛋白原

Abstract：Objective Through the detection of prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen (FIB) content and thrombin time (TT) in different stages of disseminated intravascular coagulation (DIC), to discuss the relationship between the degree of DIC and the four levels of blood coagulation, and to evaluate the value of four items of blood coagulation in the clinical diagnosis of DIC.Methods From March 2018 to April 2019, 90 patients with known DIC related basic diseases were selected.According to early diagnosis, they were divided into hypercoagulable group, the lysozyme group and the fibrinolytic group, with 30 cases in each group.In addition, 30 healthy volunteers in the same period were randomly selected as the control group, and four blood coagulation levels in each group were measured, and the relationship between the four items of hemagglutination and the course of DIC was analyzed.Results PT and APTT of the hypercoagulable group, the lysozyme group and the fibrinolytic group were longer than those of the control group, and the differences were statistically significant (P＜0.05).TT of the lysozyme group and the fibrinolytic group were longer than that of the control group, and FIB was lower than that of the control group, the differences were statistically significant (P＜0.05).There was no significant difference in TT and FIB content between the hypercoagulant group and the control group (P＞0.05).The APTT of the lysozyme group was longer than that of the hypercoagulant group, and the FIB content of the lysozyme group was lower than that of the hypercoagulant group, the differences were statistically significant (P＜0.05).PT, APTT and TT in the fibrinolytic group were longer than those in the hypercoagulant group, and the content of FIB was lower than those in the hypercoagulant group, with statistically significant difference (P＜0.05).PT, APTT and TT in the fibrinolytic group were longer than those in the lysozyme group, and the content of FIB in the fibrinolytic group was lower than that in the lysozyme group, with statistically significant difference (P＜0.05).Linear correlation analysis showed that PT, APTT were positively correlated with the course of DIC (r=0.81, 0.77; P＜0.05).FIB was negatively correlated with the course of DIC (r=-0.72, P＜0.05).TT was not correlated with the course of DIC (P＞0.05).Conclusion The four indexes of hemagglutination have significant differences in different periods of DIC.The early detection and analysis of each index is helpful to the clinical diagnosis of early DIC and the prediction of the development period of DIC.

Key words： Disseminated intravascular coagulation Four items of hemagglutination Prothrombin time Activated partial prothrombin time Fibrinogen

作者简介: 井峰，男，本科，检验师，主要从事血凝、血气、生化、发光、免疫等方面的研究

引用本文:

井峰. 血凝四项在不同程度弥散性血管内凝血中的对比研究[J]. 中国当代医药, 2020, 27(8): 162-165.
JING Feng. Comparative study of four items of hemagglutination in different degrees of diffuse intravascular coagulation. 中国当代医药, 2020, 27(8): 162-165.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I8/162

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