【摘要】 探讨慢性重型肝炎患者血清中凝血因子Ⅴ、Ⅶ、Ⅹ水平的动态变化及临床意义。方法:78例慢性重型肝炎患者分为死亡组和存活组,前者分为早期、中期、晚期,后者分为早期、恢复期,采用血凝法动态检测两组各期及对照组中患者凝血因子Ⅴ、Ⅵ、Ⅹ的水平,并比较它们之间的差异。结果:慢性重型肝炎患者死亡组早期凝血因子Ⅴ、Ⅶ、Ⅹ水平分别为34.64±2.89、20.96±2.23、42.62±3.28,中期分别为22.81±2.28、14.40±1.63、32.67±2.70,晚期分别为14.25±1.76、9.90±1.48、25.76±2.44,均显著低于正常对照组,且随肝功能受损程度加剧而呈进行性降低,其中19因子下降最明显。存活组早期3种因子水平分别为45.58±8.69、21.96±6.61、42.27±12.25,均显著低地正常对照组。恢复期中Ⅶ因子为68.85±31.74,Ⅹ因子为64.12±11.65,仍低于正常对照组(P<0.05),但Ⅴ因子与对照组相比差异无显著性(P>0.05)。在存活组与死亡组的早期Ⅴ因子的活性有显著性差异(t=2.44,P<0.05),而Ⅶ因子、Ⅹ因子差异无显著性(t值分别为0.38、0.09,P>0.05)。结论:动态观察凝血因子Ⅴ、Ⅶ、Ⅹ水平的变化,对慢性重型肝炎的早期诊断和判断预后有一定价值。Ⅶ因子是较灵敏的指标,Ⅴ因子是判断预后的最好指标,由于凝血酶原时间(PT)和凝血酶原活动度(PTA)的更多还原

【Abstract】 To explore dynamic change and clinical significance of coagulation factor Ⅴ 、 Ⅶ、 Ⅹ in chronicsevere hepatitis. Methods: 108 cases were observed which was devided into death、 survival and health groups. Three groups were 65 cases、13 cases、30 cases, respectively. The serum level of coagulation factor Ⅴ 、Ⅶ、Ⅹ were dynamically measured by Thrombolyzer (provided by BE company, Germany). Results: Compared with healthy controls, coagulation factor Ⅴ、Ⅶ、 Ⅹwere significantly decreased among death group whether in early stage, metaphase, or advanced stage, and the same in early stage of survival group. Among survival group, in restoration stage, factor Ⅶ、Ⅹ were also significantly decreased (P<0. 05) , while factor Ⅴ had no statistical significance (P>0.05). Comparing death group to survival one in early stage, factor Ⅴ was significantly different (P<0. 05), while factor Ⅶ、 Ⅹ had no statistical significance (P>0. 05). Conclusions: Dynamic measurement of coagulation factor Ⅴ、Ⅶ、 Ⅹ are conductive to both the diagnosis and prognosis of chronic severe hepatitis. Factor Ⅶ is a sensitive index for early diagnosing, and factorⅤ is the best prognostic one. It could be complemented by PTA or PT.更多还原