乙型肝炎后肝硬化早期门脉高压实验室指标变化规律的研究
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摘要
目的探讨乙型肝炎后肝硬化患者未成熟血小板分数(IPF)、高荧光强度未成熟血小板分数(HIPF)、清蛋白(ALB)、纤维蛋白原(Fbg)、肝脏门静脉内径、腹水生成、脾脏大小等指标在门脉高压形成过程中的变化规律。方法纳入该院80例乙型肝炎后肝硬化患者作为病例组,48例健康者作为对照组,分别对2组研究对象的IPF、H-IPF、ALB、Fbg、肝脏门静脉内径、腹水生成、脾脏大小等指标进行分析。结果病例组ALB、Fbg均低于对照组(P<0.05);对照组IPF、H-IPF明显低于病例组(P<0.05);病例组的血小板减少亚组IPF、H-IPF、门静脉内径均大于血小板正常亚组(P<0.05);ALB与门静脉内径相关性较弱。脾大患者的ALB明显低于脾正常患者(P<0.05);腹水患者的ALB明显低于非腹水患者(P<0.05)。结论 IPF和H-IPF可有效评估乙型肝炎后肝硬化门脉高压的形成。
Objective To investigate the performance of immature platelet fraction(IPF),highly fluorescent immature platelet fraction(H-IPF),albumin(ALB),fibrinogen(Fbg),portal vein diameter,ascites and spleen size in patients with post-hepatitic B liver cirrhosis.Methods IPF,H-IPF,ALB,Fbg,portal vein diameter,ascites and spleen size were determined for 80 patients with post-hepatitic B liver cirrhosis(cases group),while 48 healthy populations who were recruited in Nanfang Hospital were selected as control group.ResultsALB and Fbg in case group were significantly lower than that of control group(P<0.05).IPF and H-IPF of control group were significantly lower than that of case group(P<0.05).IPF,H-IPF and portal vein diameter of the thrombocytopenia group were significantly higher than those of the platelet count normal group(P<0.05).There were no correlation between ALB and portal vein diameter(P>0.05).ALB in patients with splenomegaly was significantly lower than that in patients with normal size spleen.ALB in patients with ascites was significantly lower than that in patients without ascites(P<0.05).Conclusion IPF and H-IPF could be recommended for evaluating the process of portal hypertension.
Objective To investigate the performance of immature platelet fraction(IPF),highly fluorescent immature platelet fraction(H-IPF),albumin(ALB),fibrinogen(Fbg),portal vein diameter,ascites and spleen size in patients with post-hepatitic B liver cirrhosis.Methods IPF,H-IPF,ALB,Fbg,portal vein diameter,ascites and spleen size were determined for 80 patients with post-hepatitic B liver cirrhosis(cases group),while 48 healthy populations who were recruited in Nanfang Hospital were selected as control group.ResultsALB and Fbg in case group were significantly lower than that of control group(P<0.05).IPF and H-IPF of control group were significantly lower than that of case group(P<0.05).IPF,H-IPF and portal vein diameter of the thrombocytopenia group were significantly higher than those of the platelet count normal group(P<0.05).There were no correlation between ALB and portal vein diameter(P>0.05).ALB in patients with splenomegaly was significantly lower than that in patients with normal size spleen.ALB in patients with ascites was significantly lower than that in patients without ascites(P<0.05).Conclusion IPF and H-IPF could be recommended for evaluating the process of portal hypertension.
引文
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[12]BATALLER R,BRENNER D A.Liver fibrosis[J].J Clin Invest,2005,87(15):209-218.
[13]GRESSNER O A,GAO C F.Monitoring fibrogenic progression in the liver[J].Clin Chim Acta,2014,433(30):111-122.
[14]SCHUPPAN D,AFDHAL N H.Liver cirrhosis[J].Lancet,2008,371(56):838-851.
[15]BERZIGOTTI A,SEIJO S,REVERTER E,et al.Assessing portal hypertension in liver diseases[J].Expert Rev Gastroenterol Hepatol,2013,7(2):141-155.
[2]LOK A S,MCMAHON B J.Chronic hepatitis B:update2009[J].Hepatology,2009,50(3):661-662.
[3]BERZIGOTTI A,SEIJO S,ARENA U,et al.Elastography,spleen size,and platelet count identify portal hypertension in patients with compensated cirrhosis[J].Gastroenterology,2013,144(21):102-111.
[4]王修石,冷小艳.肝硬化患者网织血小板和血小板参数的临床应用价值[J/CD].中国肝脏病杂志(电子版),2016,8(2):82-85.
[5]吴红丽,孙岳枫.肝硬化患者凝血功能、血小板参数、网织红细胞参数的变化与Child-Pugh分级的关系[J].国际检验医学杂志,2016,37(7):907-909.
[6]PAPASTERGIOU V,TSOCHATZIS E,BURROUGHSA K.Non-invasive assessment of liver fbrosis[J].Ann Gastroenterol,2012,25(3):218-31.
[7]DOU J,LOU Y,WU J,et al.Thrombocytopenia in patients with hepatitis B virus-related chronic hepatitis:evaluation of the immature platelet fraction[J].Platelets,2014,25(6):399-404.
[8]ZHU C,QI X,Li H,et al.Correlation of serum liver fbrosis markers with severity of liver dysfunction in liver cirrhosis:a retrospective crosssectional study[J].Int J Clin Exp Med,2015,8(4):5989-5998.
[9]JARCUSKA P,JANICKO M,VESELINY E,et al.Circulating markers of liver fbrosis progression[J].Clin Chim Acta,2010,411(15/16):1009-1017.
[10]朱大年.生理学[M].8版.北京:人民卫生出版社,2013:58-61.
[11]崔文娟,朱凤群.慢性乙型肝炎肝硬化血小板减少影响因素的研究进展[J].实用肝脏病杂志,2010,13(1):78-80.
[12]BATALLER R,BRENNER D A.Liver fibrosis[J].J Clin Invest,2005,87(15):209-218.
[13]GRESSNER O A,GAO C F.Monitoring fibrogenic progression in the liver[J].Clin Chim Acta,2014,433(30):111-122.
[14]SCHUPPAN D,AFDHAL N H.Liver cirrhosis[J].Lancet,2008,371(56):838-851.
[15]BERZIGOTTI A,SEIJO S,REVERTER E,et al.Assessing portal hypertension in liver diseases[J].Expert Rev Gastroenterol Hepatol,2013,7(2):141-155.