The Study On The Clinic Value Of Coagulation Index In Liver Disease Diagnosis And Treatment

Objective:To study the clinic value of coagulation index in diagnosis-treatment, condition-observation, prognosis and DIC in patients with liver disease. Methods: Forty-two patients with acute hepatitis(AH),58 chronic hepatitis(CH), 12 stable cirrhosis (LC-1),67 advanced cirrhosis(LC-2),44 chronic severe hepatitis (CSH),37 stable liver cancer(CA-l),28 advanced liver cancer(CA-2),and 19 healthy persons(N) were collected.PT/PA,APTT,FIB,V,VII,VIII were detected with clooting assay,DD was detected with immunoturbidimetric assay,F1+2 was detected with ELISA. Results:l.The difference of VII between CH and N was statistically significant;The differences of DD, PT,PA,V,VII,VIII,PLT,APTT,FIB in LC-2 and CSH compared with N,AH,CH were all statistically significant. 2.Correlation analysis indicated that VII correlated the best with PA in patients with LC-2,but V correlated the best with PA in patients with CSH. 3.In advanced liver disease,the differences of DD,PA,APTT,V between bleeding and non-bleeding group were statistically significant;the difference of DD between encephalopathy and non-encephalopathy, the differences of DD,V,VII between ascites and non-ascites,and the differences of PA,V,VII between oesophageal and/or gastric fundus varices and non-oesophageal were also statistically significant. 4.The differences of DD,PA,APTT,V between died group and turned-better group were statistically significant,96.9% patients of PT>120s died . 5.The rate of DIC in advanced liver disease was 4.26%, latent DIC was 6.9%. 6. In patients with DIC, almost all the level of DD increased 10 times above,F1+2 increased 2.5 times above,VIII<50% in 62.5% patients .7. Five of 8 patients with DIC, PLT,FIB,PT,VIII,DD and F1+2 were all accord with the diagnostic criterion,but other 3 patients only VIII was not accord with the diagnostic criterion(VIII<50%).Conclusions:1 .VII occures early than PT/PA reflecting the abnormality of liver.2. DD,PT,PA,APTT,FIB,V,Vn,PLT have a better diagnostic value for CSH and LC-2.3.PT,PA,APTT,V,VH,FIB have some extent of differential value for LC-1 and LC-2;DD,PA,V,VII have some extent of differential value for CA-1 and CA-2;PT,PA,APTT have some extent of differential value for CSH and LC-2. 4.V is a good diagnostic index for CSH. 5.APTT can be one of the diagnostic criteria for CSH .6. In advanced liver disease, DD,PA,APTT,V have some extent of predictable value for bleeding;and DD for encephalopathy, DD,V,VII for ascites, PA,V,VII for oesophageal and/or gastric fundus varices all have some extent of predictable value.7. DD,PA,APTT,V have important value for the prognosis of severe liver disease8. When PT>120s in patients with liver disease ,about 97% patients died or give up medical treatment during 1 to 10 days,however,the treatment of the internal medicine have no curative effect.9. The rate of DIC in advanced liver disease is 4.26%, latent DIC is 6.9%.10.DD increasing 10 times or above and Fl+2 increasing 2.5 times or above have had thediagnostic values for DIC with liver disease. 11.It may be more exactly that we take VIII<50% or VIII decreased gradually as thedifferential index for DIC with liver disease..