肝硬化合并与不合并原发性肝癌患者血小板数目及凝血功能差异比较研究*

doi:10.3969/j.issn.1672-5069.2025.04.025

实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (4): 577-580.doi: 10.3969/j.issn.1672-5069.2025.04.025

肝硬化合并与不合并原发性肝癌患者血小板数目及凝血功能差异比较研究^*

张萌, 党至纯, 李婷, 刘晨瑞, 王沐淇, 吴姣姣, 贺娜, 李亚萍

710004 西安市西安交通大学第二附属医院感染病科(张萌,李婷,刘晨瑞,王沐淇,吴姣姣,李亚萍);西安医学院第一附属医院消化内科(党至纯,贺娜)

收稿日期:2024-11-20 出版日期:2025-07-10 发布日期:2025-07-14
通讯作者: 李亚萍,E-mail:liyaping8605@126.com;共同通讯作者:贺娜,E-mail:ylhena@163.com
作者简介:张萌,女,24岁,博士研究生。E-mail: zhangmeng8388@126.com;共同第一作者:党至纯,女,22岁,本科生。E-mail: liiing2022@126.com
基金资助:
^*陕西省大学生创新创业训练计划-创新训练项目(121524049)

Platelet counts and coagulation functions in patients with primary liver cancer with underlying liver cirrhosis

Zhang Meng, Dang Zhichun, Li Ting, et al

Department of Infectious Diseases, Second Affiliated Hospital, Jiaotong University, Xi'an 710004, Shaanxi Province, China

Received:2024-11-20 Online:2025-07-10 Published:2025-07-14

摘要/Abstract

摘要： 目的分析比较肝硬化合并与不合并原发性肝癌(PLC)患者血小板数目及凝血功能指标变化的差异。方法 2022年10月～2023年12月西安交通大学第二附属医院感染病科收治的肝硬化合并PLC患者80例和肝硬化患者80例,使用血栓弹力图(TEG)检测外周血凝血功能指标,记录最大振幅(MA)、凝血反应时间(R)、血凝块形成时间(K)、Angle角(Angle)和综合凝血指数(CI)。结果肝硬化与PLC患者血小板计数和MA均显著减少,但两组间比较无显著性差异(P>0.05);PLC患者血清纤维蛋白(原)降解产物和D二聚体水平显著高于肝硬化患者(P<0.05);在肝功能Child B/C级,64例PLC患者MA和CI分别为49.0(40.8,54.2)和-1.5(-3.7,0.2),均显著大于33例肝硬化患者【分别为42.5(31.0,50.2)和-3.2(-7.3,-0.2),P<0.05】, 血清纤维蛋白(原)降解产物和D二聚体分别为5.3(2.9,12.0) μg/mL和1750.0(870.0,5285.0)ng/mL,均显著高于肝硬化患者【分别为2.1(1.5,4.0) μg/mL和740.0(527.5,1522.5) ng/mL,P<0.05】,而血清纤维蛋白原水平为1.5(1.1,2.4) g/L,显著低于肝硬化患者【2.1(1.7,2.7) g/L,P<0.05】。结论肝硬化合并PLC患者可能存在更为复杂的凝血功能异常,其中可能涉及血小板计数和功能的变化,值得深入研究。

关键词: 原发性肝癌, 血栓弹力图, 血小板功能

Abstract: Objective The aim of this study was to compare discrepancy of platelet and coagulation functions between patients with liver cirrhosis (LC) and patients with primary liver cancer (PLC) and underlying LC. Methods A total of 80 patients with LC and another 80 patients with PLC and underlying LC were encountered in Department of Infectious Diseases, Second Affiliated Hospital, Xi 'an Jiaotong University between October 2022 and December 2023, and thromboelastography (TEG) was conducted to record maximum amplitude (MA), react time (R),kinetic time (K),alpha angle (Angle) and clot index (CI). Results There were no significant differences as respect to platelet counts and MA between patients with PLC and LC, although the parameters decreased greatly in both patients of PLC and LC(P>0.05); serum fibrinogen degradation products (FDP) and d-dimer (D-D) levels in patients with PLC were significantly higher than in those with LC (P<0.05); in patients with liver function Child class B/C, MA and CI in 64 patients with PLC were 49.0(40.8, 54.2) and -1.5(-3.7, 0.2), both much greater than [42.5(31.0, 50.2) and -3.2(-7.3,-0.2), respectively, P<0.05], and serum FDP and D-D levels were 5.3(2.9,12.0) μg/mLand 1750.0(870.0, 5285.0)ng/mL, both much higher than [2.1(1.5, 4.0) μg/mLand 740.0(527.5, 1522.5) ng/mL, respectively, P<0.05], while serum fibrinogen level was 1.5(1.1, 2.4) g/L, much lower than [2.1(1.7, 2.7) g/L,P<0.05] in 33 patients with LC. Conclusions Patients with PLC and underlying LC could have even more sophisticated coagulation function disorders, which might involve platelet functionchanges and warrants further investigation.

Key words: Hepatoma, Thromboelastography, Platelet functions

张萌, 党至纯, 李婷, 刘晨瑞, 王沐淇, 吴姣姣, 贺娜, 李亚萍. 肝硬化合并与不合并原发性肝癌患者血小板数目及凝血功能差异比较研究^*[J]. 实用肝脏病杂志, 2025, 28(4): 577-580.

Zhang Meng, Dang Zhichun, Li Ting, et al. Platelet counts and coagulation functions in patients with primary liver cancer with underlying liver cirrhosis[J]. Journal of Practical Hepatology, 2025, 28(4): 577-580.

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肝硬化合并与不合并原发性肝癌患者血小板数目及凝血功能差异比较研究^*

Platelet counts and coagulation functions in patients with primary liver cancer with underlying liver cirrhosis

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