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急性胰腺炎患者出凝血指标变化的临床意义

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目的:探讨急性胰腺炎患者出凝血指标变化对于临床治疗的指导意义.方法:选择发病24 h内入院的急性胰腺炎患者108例,按分级标准分为轻型和重型两组,其中轻型68例、重型40例,选健康体检者60例,分别空腹取血2 mL,进行出凝血功能检测,比较各组结果.结果:急性胰腺炎患者凝血酶原时间(PT),部分活化凝血酶原时间(APTT),纤维蛋白原(FTB),D-二聚体(D-D)的水平轻型组(MAP)与对照组比较轻度升高,但无统计学意义(P>0.05),重症急性胰腺炎患者组(SAP)与对照组及MAP组相比较均明显增高,有统计学意义(P<0.05),并且SAP患者FIB和D-D值与APACHEⅡ评分值之间存在正相关关系(r=0.84,r=0.86).从住院时间、并发症发生率、死亡率情况比较,SAP组患者均较MAP组患者高(P<0.05).结论:出凝血功能指标可以很好地反应胰腺炎轻重程度,初步判断胰腺炎的预后及了解病情变化,从而作为临床胰腺炎治疗的重要参考指标.
Clinical significance and alteration of coagulation function in acute pancreatitis
AIM:To investigate the relationship between the alteration of coagulation function and symptoms of acute pancreatitis. METHODS: One hundred and eight cases with acute pancreatitis who had been admitted to hospital within 24 h were divided intomild acute pancreatitis (MAP) group (68 cases) and sever acute pancreatitis(SAP) gtoup(40 cases) according to "The Standard of Clinical Diagnosis and Classification of Acute Pancreatitis",and 60 healthy people were included in the study as control. The coagulation function of the 3 groups were examined and analyzed. RESULTS: The data of MAP group were a little higher than that of healthy,but there was no significant difference between the 2 groups( MAP vs Healthy,P > 0. 05). The data of MAP group were much higher than that of SAP group and healthy group,and there was a significance difference between them(SAP vs MAP,SAP vs Healthy,P<0.05). The data of FIB and D-D of SAP group were positively correlated with the APACHEⅡ score(r=0.84,r=0.86). The length of stay,the incidence rate of complications and the mortality in SAP group were higher than those of MAP group(SAP vs MAP,P<0.05). CONCLUSION: The coagulation function can reflect the severity of acute pancreatitis and is of some value in the treatment and prognosis of acute pancreatitis.

acute pancreatitiscoagulation functionprognosisAPACHE Ⅱ score

宋冰、张文婧、候鹏、谷川

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天津医科大学研究生院,天津,300070

天津市第一中心医院普外科,天津,300192

急性胰腺炎 凝血功能 预后 APACHEⅡ评分

2009

第四军医大学学报
第四军医大学

第四军医大学学报

CSTPCDCSCD北大核心
影响因子:0.599
ISSN:1000-2790
年,卷(期):2009.30(7)
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