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目的探讨慢性丙型肝炎患者凝血功能与血清HCV-RNA含量之间的关系及其意义。方法收集广州市第八人民医院慢性丙型肝炎患者182例,健康人群20例作为正常对照组,慢性丙型肝炎患者根据HCV-RNA含量分为A组(HCV-RNA含量:<105IU/ml)、B组(HCV-RNA含量:105~IU/ml)、C组(HCV-RNA含量:106~IU/ml)、D组(HCV-RNA含量:107~IU/ml)。分别检测其血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、凝血酶时间(TT)、血浆纤维蛋白原(FIB)四项凝血功能指标及血清HCV-RNA含量。分析PT、APTT、TT、FIB指标在不同血清HCV-RNA含量组中的变化及其意义。结果除FIB值外,不同HCV-RNA含量组之间PT、APTT、TT比较差异均有统计学意义(χ2PT=32.91,χ2APTT=25.78,χ2TT=43.14,P均=0.000)。各组PT、APTT、TT值与正常对照组比较,差异均有统计学意义(P<0.05),特别是病毒含量≥105IU/ml时,与正常对照组比较差异有显著统计学意义(P<0.01)。对于FIB值,除了病毒含量≥107IU/ml≥106~<107IU/ml组外,其余两组与正常对照组比较差异均有统计学意义(P<0.05)。结论慢性丙型肝炎患者凝血功能随着病人体内HCV-RNA含量的增加有逐渐降低的趋势,特别是对于HCV-RNA含量≥106IU/ml的病人,应随时监测病人的凝血功能,以防出现严重的出血。
Objective To investigate the relationship between coagulation function and serum HCV-RNA content in patients with chronic hepatitis C and its significance. Methods A total of 182 patients with chronic hepatitis C in Guangzhou Eighth People’s Hospital and 20 healthy individuals were enrolled as normal control group. Patients with chronic hepatitis C were divided into group A (HCV-RNA content: <105 IU / ml) , Group B (HCV-RNA content: 105 ~ IU / ml), group C (HCV-RNA content: 106 ~ IU / ml) and group D (HCV-RNA content: 107 ~ IU / ml). The levels of plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), and serum HCV-RNA were measured. The changes and significance of PT, APTT, TT and FIB in different serum HCV-RNA content groups were analyzed. Results There were significant differences in PT, APTT and TT among groups with different HCV-RNA content except FIB (χ2PT = 32.91, χ2APTT = 25.78, χ2TT = 43.14, P = 0.000). The differences of PT, APTT and TT between the two groups were statistically significant (P <0.05), especially when the virus content was more than or equal to 105IU / ml, there was significant difference compared with the normal control group (P < 0.01). For the FIB value, except for the virus content ≥107IU / ml≥106 ~ <107IU / ml group, there was significant difference between the other two groups and the normal control group (P <0.05). Conclusion The coagulation function of patients with chronic hepatitis C tends to decrease gradually with the increase of HCV-RNA in patients, especially in patients with HCV-RNA content ≥ 106IU / ml, the patient’s coagulation function should be monitored at any time to prevent serious occurrence Bleeding.