[Fibrinolytic activities and their relations to esophageal variceal bleeding in patients with liver cirrhosis].
OBJECTIVE
Esophageal variceal bleeding in liver cirrhosis is a major complication and has high mortality rate. We tried to find fibrinolytic parameters, which correlated with variceal bleeding in cirrhotic patients.


METHODS
We divided the cirrhotic patients into two groups: bleeding group (group A, n=15) and non-bleeding group (Group B, n=17). Fibrinolytic parameters (fibrinogen, D-dimer, plasminogen, tissue plasminogen activator [t-PA], fibrin degradation product [FDP], and plasminogen activator inhibitor type-1 [PAI-1]) were compared between two groups. In the group A, serial samplings were taken at the initial period, 3 days, 8 days, 15 days and 6 weeks after the bleeding onset.


RESULTS
Plasma levels of FDP and D-dimer in the group A were significantly higher than the group B (1.7 +/- 1.16 vs. 0.95 +/- 1.27 mg/L and 10.96 +/- 6.58 vs. 4.99 +/- 3.50 micro gram/mL, respectively, p value<0.05). The clinical, biochemical, and coagulation parameters didn't show significant differences in both groups. The fibrinolytic parameters were improved along with the hemodynamic stabilization in group A.


CONCLUSIONS
Cirrhotic patients with increased fibrinolytic activity were at higher risk of bleeding. Thus, the measurement of these parameters would be useful to identify patients at higher risk of esophageal variceal bleeding.
Yun
Jung Won
JW
Department of Internal Medicine, Sungkyunkwan University School of Medicine, Korea.
Kim
Byung Ik
BI
Chun
Han Byul
HB
Hwang
Sang Tai
ST
Kim
Jeong Wook
JW
Park
Dong Il
DI
Cho
Yong Kyun
YK
Sung
In Kyung
IK
Park
Chang Young
CY
Sohn
Chong Il
CI
Jeon
Woo Kyu
WK
D000328:Adult; D001777:Blood Coagulation; D004932:Esophageal and Gastric Varices / Q000097:blood / Q000150:complications*; D005342:Fibrinolysis; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000209:etiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged