本文關(guān)鍵詞： 急性上消化道出血 D-二聚體 血小板 凝血酶原時(shí)間 部分活化凝血活酶時(shí)間　出處：《青海大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:通過測(cè)定青海地區(qū)急性上消化道出血患者外周血中D-二聚體(DD)、血小板(PLT)、凝血酶原時(shí)間(PT)及活化部分凝血活酶時(shí)間(APTT)的水平變化,試圖研究這四種實(shí)驗(yàn)室指標(biāo)的水平變化與不同病因引起的急性上消化道出血的聯(lián)系,為臨床醫(yī)生初步判斷急性上消化道出血病因提供一定的參考依據(jù)。方法:1.收集2015年11月至2016年11月在青海大學(xué)附屬醫(yī)院住院確診的急性上消化道出血患者160例。2.收集患者入院初接受治療前的相關(guān)化驗(yàn)指標(biāo):DD、PLT、PT、APTT的測(cè)定值。3.資料分組:肝病所致急性上消化道出血患者52例(乙肝組42例,丙肝組10例),胃癌所致急性上消化道出血患者37例,潰瘍所致急性上消化道出血患者71例(GU32例,DU39例)4.應(yīng)用全自動(dòng)血凝儀測(cè)定DD、PT、APTT的水平,采用血液細(xì)胞分析儀檢測(cè)PLT。結(jié)果:1.DD:各組的DD比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.001),肝病組比胃癌組、潰瘍組的DD水平有明顯升高,胃癌組比潰瘍組DD升高;2.PLT比較:肝病組其水平降低明顯,胃癌組和潰瘍組PLT水平無明顯的差異(P0.05)。3.PT比較:肝病組PT的測(cè)定值升高明顯,胃癌組和潰瘍組PT無明顯的差異(P0.05)。4.APTT比較:肝病組APPT的測(cè)定值升高明顯,胃癌組和潰瘍組APPT的檢測(cè)值無明顯的差異(P0.05)。5.DD、PLT、PT、APTT在肝病組中的乙肝組和丙肝組比較結(jié)果顯示無明顯差異(P0.05);DD在潰瘍組中DU組和GU組比較(P0.05)差異有統(tǒng)計(jì)學(xué)意義,PLT、PT、APTT在GU組和DU組間比較無明顯差異(P0.05)。結(jié)論:1.青海地區(qū)在引起急性上消化道出血的三種疾病中,潰瘍所占比重最高,肝病次之,胃癌最低。2.青海地區(qū)在不同病因所致AUGIB的病人外周血中DD、PLT、PT、APTT的水平不同。3.肝病并AUGIB患者外周血DD、PT、APTT水平高于胃癌并AUGIB和潰瘍并AUGIB的患者,PLT水平明顯低于胃癌并AUGIB和潰瘍并AUGIB的患者。胃癌并AUGIB患者DD水平高于潰瘍并AUGIB;胃癌并AUGIB患者外周血PLT、PT、APTT水平和潰瘍并AUGIB組無明顯差異。4.肝病并AUGIB患者中乙肝組與丙肝組患者外周血DD、PLT、PT、APTT無明顯差異;潰瘍并AUGIB患者中GU組患者DD水平稍高于DU組,PLT、PT、APTT水平無明顯差異。
[Abstract]:Objective: to determine the level of D-dimer in peripheral blood of patients with acute upper gastrointestinal hemorrhage in Qinghai area. The changes of prothrombin time (PTT) and activated partial thromboplastin time (APTT) were studied to study the relationship between the changes of these four laboratory indexes and acute upper gastrointestinal bleeding caused by different etiology. To provide a reference for clinicians to judge the etiology of acute upper gastrointestinal hemorrhage. Methods:. 1. To collect 160 cases of acute upper gastrointestinal bleeding diagnosed from November 2015 to November 2016 in the affiliated Hospital of Qinghai University. Marks:. DD. Data group: 52 patients with acute upper gastrointestinal hemorrhage caused by liver disease (hepatitis B 42 cases, hepatitis C 10 cases). There were 37 patients with acute upper gastrointestinal hemorrhage caused by gastric cancer and 71 patients with acute upper gastrointestinal hemorrhage caused by ulcer. The level of APTT was detected by blood cell analyzer. Results: 1. The DD of each group was significantly higher than that of gastric cancer group (P 0.001), and that of liver disease group was higher than that of gastric cancer group. DD level in ulcer group was significantly higher than that in gastric cancer group. 2. Comparison of PLT: the level of PLT decreased significantly in liver disease group, but there was no significant difference between gastric cancer group and ulcer group. 3. PT comparison: PT in liver disease group increased significantly. There was no significant difference in PT between gastric cancer group and ulcer group (P 0.05). 4. Comparison of APTT: the value of APPT in liver disease group was higher than that in control group. There was no significant difference in the detection value of APPT between gastric cancer group and ulcer group. The comparison of APTT in hepatitis B group and hepatitis C group showed that there was no significant difference between hepatitis B group and hepatitis C group (P 0.05). DD in the ulcer group DU group and gu group compared with P0.05) there was a significant difference between DU group and gu group (P 0.05). There was no significant difference in APTT between gu group and DU group. Conclusion 1. Among the three diseases causing acute upper gastrointestinal hemorrhage in Qinghai area, ulcers account for the highest proportion, followed by liver diseases. The level of APTT in peripheral blood of patients with AUGIB caused by different etiology in Qinghai area is different. The level of APTT in patients with liver disease and AUGIB is different. DD in peripheral blood of patients with liver disease and AUGIB is different. The level of PTT APTT in gastric cancer patients with AUGIB and ulcer with AUGIB was higher than that in patients with gastric cancer and ulcer with AUGIB. The level of PLT was significantly lower in patients with gastric cancer with AUGIB and ulcers with AUGIB. The DD level of patients with gastric cancer with AUGIB was higher than that with ulcer with AUGIBB. There was no significant difference in APTT levels in peripheral blood between patients with gastric cancer and AUGIB and those with AUGIB and ulcer. 4. DD in peripheral blood of patients with hepatitis B and hepatitis C in patients with liver disease and AUGIB. There was no significant difference in APTT between PLT and PTT. There was no significant difference in DD level in patients with ulcer and AUGIB compared with that in DU group.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R573.2

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