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目的：探讨乙型肝炎患者凝血功能与血清胱抑素C 联合检测的临床诊断价值。方法：收集260 例乙型肝炎患者为实验组及健康者70 例为对照组，采用全自动凝血分析仪进行活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)的测定，采用全自动生化分析仪进行血清胱抑素C、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、血清γ 谷氨酰转肽酶（GGT）的检测。结果：除急性肝炎组外,其他各组乙型肝炎患者的APTT、PT 值均高于对照组(P<0.05)。重型肝炎和肝炎肝硬化组FIB 值均低于对照组(P<0.05)；对于血清胱抑素C 水平，除急性肝炎组外,其他各组值均明显高于健康对照组(P<0.05)，且肝炎肝硬化组依次高于重型肝炎组和慢性肝炎组。各实验组ALT 和AST 水平均明显高于对照组(P<0.05)，而对于GGT 水平，重型肝炎组和肝炎肝硬化组明显高于对照组(P<0.05)。结论：联合检测APTT、PT、FIB 凝血功能指标与血清胱抑素C 水平，对临床判断乙型肝炎患者病变程度及预后具有重要意义。

英文摘要:

Objective: To explore the diagnostic value of the combined detection of blood coagulation function and serum cystatin C in patients with hepatitis B. Methods: Two hundred and sixty cases of patients with hepatitis B (test group) and seventy healthy individuals( control group) were enrolled in the study. We measured activated partial thromboplastin time (APTT), prothrombin time(PT) and fibrinogen (FIB) by Automated coagulation analyzer,and detected the content of cystatin C, alanine aminotransferase (ALT) , aspartate aminotransferase (AST) and γ-glutamyl transferase (GGT) by Automatic biochemical analyzer in the test and control groups.Results: Except the acute hepatitis group, APTT and PT value of the test group were all higher than the control (P<0.05).FIB of the severe hepatitis group and hepatitis cirrhosis group were both significantly lower than the control group (P<0.05); Except the acute hepatitis group, cystatin C value of the hepatitis B patients were all higher than the control (P<0.05),and the value of hepatitis cirrhosis group , severe hepatitis group and chronic hepatitis was sorted in desending order . For ALT and AST the value of each test group was higher than the control (P<0.05), GGT value of the hepatitis cirrhosis group and severe hepatitis group were both higher than the control (P<0.05). Conclusion：The combined detection of blood coagulation function indexes （APTT,PT,FIB）and serum cystatin C are useful to evaluate liver damage and predict the aggravation for hepatitis B.

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