CAJ | 학술논문

目的：初步探讨肝炎后肝硬化患者D-二聚体（D-Dimer, DD）、血小板相关免疫球蛋白G（Platelet-associated Immunoglobulin G, PAIgG）变化及临床意义。方法肝炎后肝硬化患者55例，并按Child-Pugh肝功能分级，A级18例、B级17例、C级20例，健康对照组20名，检测DD、PAIgG的水平变化。另按有无出血现象对肝炎后肝硬化患者进行分组，出血组患者30例，无出血组患者25例，从而对上述指标进行两组间比较。结果(1)肝炎后肝硬化患者A、B、C组与对照组比较，DD随肝炎后肝硬化的严重程度而升高，各组之间比较差异均有统计学意义（P＜0.05）；(2)PAIgG在肝炎后肝硬化各组均明显高于对照组（P＜0.05），A组与B组之间差异无统计学意义（P＞0.05），C组则明显高于A组、B组及对照组（P＜0.05）；(3)肝炎后肝硬化患者，DD在出血组明显高于无出血组，两组之间比较差异有统计学意义（P＜0.05），PAIgG则在出血组与无出血组之间差异无统计学意义（P＞0.05）。结论肝炎后肝硬化患者存在明显的凝血、抗凝血以及纤溶机制的异常，且与肝炎后肝硬化肝功能Child-Pugh分级密切相关。
목적：초보탐토간염후간경화환자D-이취체（D-Dimer, DD）、혈소판상관면역구단백G（Platelet-associated Immunoglobulin G, PAIgG）변화급림상의의。방법간염후간경화환자55례，병안Child-Pugh간공능분급，A급18례、B급17례、C급20례，건강대조조20명，검측DD、PAIgG적수평변화。령안유무출혈현상대간염후간경화환자진행분조，출혈조환자30례，무출혈조환자25례，종이대상술지표진행량조간비교。결과(1)간염후간경화환자A、B、C조여대조조비교，DD수간염후간경화적엄중정도이승고，각조지간비교차이균유통계학의의（P＜0.05）；(2)PAIgG재간염후간경화각조균명현고우대조조（P＜0.05），A조여B조지간차이무통계학의의（P＞0.05），C조칙명현고우A조、B조급대조조（P＜0.05）；(3)간염후간경화환자，DD재출혈조명현고우무출혈조，량조지간비교차이유통계학의의（P＜0.05），PAIgG칙재출혈조여무출혈조지간차이무통계학의의（P＞0.05）。결론간염후간경화환자존재명현적응혈、항응혈이급섬용궤제적이상，차여간염후간경화간공능Child-Pugh분급밀절상관。
Objective To investigate the changes and clinical significance of D-dimer (DD) and platelet-associated immunoglobulin G (PAIgG) in posthepatitic cirrhosis and the relationship between hemostatic changes in posthepatitic cirrosis patients with different degree of liver lesions. Methods Fifty-five patients with posthepatitic cirrhosis were divided into three subgroups (A, B, C) on the basis of Child-Pugh classification. Among the patients, 18 were classified as Child-Pugh class A, 17 were class B, 20 were class C. 20 healthy individuals served as controls. A series of tests including DD and PAIgG were performed on 55 patients and the 20 healthy controls. Furthermore, we divided the fifty-five patients with posthepatitic cirrhosis into two groups, 30 as bleeding group and 25 as non-bleeding group. The above tests were analyzed between the two groups. Results (1)DD was progressively increased form group A to group B and then to group C. In comparison to the controls there was a significant difference (P<0.05). (2)PAIgG was significantly higher in posthepatitic cirrhosis group than the control group (P<0.05). No significant differences of PAIgG were found between the group A and group B (P>0.05). Also, PAIgG was significantly higher in group C than in the other three groups (P<0.05). (3)In posthepatitic cirrhosis patients, DD was significantly higher in bleeding group than non-bleeding group, while no significant differences of PAIgG was found between the two groups (P>0.05). Conclusion We found that there is a close relationship between the coagulation disorders and the severity of posthepatitic cirrhosis, classified on the basis of Child-Pugh classification.