目的 探讨不同乙型肝炎病毒DNA(HBV-DNA)载量乙型肝炎肝硬化患者血小板参数及D-D变化情况. 方法 以2015年1月至2016年12月间我院收治的乙型肝炎肝硬化患者60例作为研究对象,所有患者均进行HBV-DNA病毒载量检测、血小板参数检测以及D-二聚体(D-D)检测.将乙型肝炎肝硬化患者按照HBV-DNA载量数量级进行分组,对各组间血小板参数及D-D表达水平进行比较.另收取同期于我院进行常规体检的健康人25例作为对照组.结果 乙型肝炎肝硬化患者血小板计数(PLT)、血小板比容(PCT)、明显低于对照组,平均血小板体积(MPV)、血小板分布宽度(PDW)及D-D明显高于对照组;检测下限组、低载量、中载量及高载量组患者之间血小板参数及D-D均存在显著差异(P<0.05),并且下限组、低载量、中载量及高载量组患者的PLT和PCT依次逐渐减小,MPV、PDW及D-D依次逐渐增大. 结论 乙型肝炎肝硬化高HBV-DNA载量患者存在明显凝血纤溶功能失衡,提示应对患者进行早期抗病毒干预,以减少病毒复制,维持凝血纤溶平衡.%Objective Discussing the change of platelet parameters and D-D detection in hepatitis B and liver cirrhosis patients with different HBV-DNA loads.Methods Hepatitis B and liver cirrhosis patients (60 cases) were selected from January 2015 to December 2016.HBV-DNA loads, platelet parameters and D-dimer(D-D) of all patients were detected.The hepatitis B and liver cirrhosis patients were grouped according with the rank of HBV-DNA loads.Platelet parameters and the expression level of D-D were compared between each group.Healthy people (25 cases) with regular physical examination were set as control group.Results The platelet count (PLT) and platelet volume (PCT) of hepatitis B and liver cirrhosis patients were significantly lower than that of control group (P<0.05);The mean platelet volume (MPV), platelet distribution width (PDW) and D-D of hepatitis B and liver cirrhosis patients were significantly higher than that of control group (P<0.05);The platelet parameters and D-D of low detection limit, low loads, intermediate loads and high loads groups had significant different from each others (P<0.05);The PLT and PCT of low detection limit, low loads, intermediate loads and high loads groups gradually decreased accordingly, while MPV, PDW and D-D increased gradually.Conclusion Hepatitis B and liver cirrhosis patients with high HBV-DNA loads show obvious blood coagulation fibrinolytic function imbalance and they should be given early antiviral intervention to reduce viral replication and maintain blood coagulation fibrinolytic balance.
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