Analysis of Four Items of Blood Coagulation and Blood Lipid In-dexes and Their Prognostic Evaluation Value in Patients with Acute Viral Hepatitis

WU Yunhui; DONG Jingchao; ZHANG Xuemian; CAO Lihua; ZHANG Jidong; MIAO Liang

doi:10.3969/j.issn.1002-3429.2024.11.010

Abstract：Objective To analyze the levels of four items of blood coagulation and blood lipid indexes in patients with acute viral hepatitis(AVH)and to evaluate their prognositc evaluation value.Methods A total of 300 patients with AVH admitted from January 1,2020 to January 31,2022 were selected as the research group and 300 healthy subjects under-going physical examination as the control group.The general data,four items of blood coagulation[prothrombin time(PT),acti-vated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)],blood lipid indexes[total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and triglyceride(TG)]of the two groups were compared.The research group received routine antiviral and liver protection therapy.Four items of blood coagula-tion and lipid indexes were compared before and after treatment in patients with different therapeutic effects in the research group,and the correlation of four items of blood coagulation and lipid indexes before treatment with the therapeutic effect as well as their value for predicting the therapeutic effect was analyzed.Results The levels of PT,APTT and TT in peripheral blood of the research group were higher than those of the control group,the levels of FIB,TC,HDL-C and LDL-C were lower than those of the control group,and the levels of TG were higher than those of the control group(P<0.01).In the research group,the peripheral blood PT,APTT and TT of the ineffective patients were longer than those of the effective and obviously effective patients before and after treatment,and longer in the effective patients than in the obviously effective patients(P<0.05).The levels of FIB,TC,HDL-C and LDL-C were lower than those of effective and obviously effective patients,and lower in the effective patients than the obviously effective patients,while the levels of TG were higher than those of effective and obvi-ously effecitve patients,and higher in effective patients than in obviously effective patients(P<0.05).In the research group,the levels of PT,APTT,TT and TG in peripheral blood after treatment were negatively correlated with the therapeutic effect,while FIB,TC,HDL-C and LDL-C were positively correlated with the therapeutic effect(P<0.05,P<0.01).Before treatment,the ar-ea under the ROC curve(AUC)of the combined prediction of four items of blood coagulation and blood lipid indexes was 0.937(95%CI:0.903,0.962),and the prediction sensitivity and specificity were 85.21%and 88.61%,respectively,which was significantly better than the prediction of four items of blood coagulation and blood lipid indexes alone(P<0.01).Conclusion Patients with AVH have obvious abnormalities in four items of blood coagulation and blood lipid indexes,and the combined detection of four items of blood coagulation and blood lipid indexes before treatment has a high value in predicting the therapeutic effect.