[The relationship between hemostatic changes in liver cirrhosis patients with different degrees of liver lesions in reference to Child-Pugh scores].
OBJECTIVE
To investigate the relationship between hemostatic changes in liver cirrhosis patients with different degrees of their liver lesions.


METHODS
Forty-three patients (35 men, 8 women; age: 25 to 71 yr) with liver cirrhosis were divided into three subgroups (A, B, and C) on the basis of Child-Pugh classification. Among the patients, 13 were classified as Child-Pugh class A, 15 were class B, 15 were class C. 16 healthy individuals served as controls. A series of hemostatic tests and parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), factors II, V, VII, VIII, IX, X, vWF assay, antithrombin-III (AT-III), protein C (PC), D-dimer, tissue plasminogen activator antigen (t-PA), plasminogen activator inhibitor activity (PAI) were performed on 43 patients and the 16 healthy controls.


RESULTS
PT and APTT were progressively prolonged from A to B and then to C. In comparison to the controls there was a significant difference. Fibrinolytic activity and the activities of factors II, V, VII, IX, X were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference . AT-III and PC activity were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference. D-dimer and t-PA-antigen were progressively increased from A to B and then to C. In comparison to the controls there was significant difference. PAI activity did not display significant changes in the four groups.


CONCLUSIONS
We found that there is a close relationship between the severity of cirrhosis and the hemostatic changes. Because the deterioration of the coagulation function and increasing fibrinolytic activity parallel the severity of liver cirrhosis, adequate treatment for cirrhotic bleeding should not only correct the coagulation defects, but also lower the increased fibrinolytic activity.
Cong
Yu-Long
YL
The General Hospital of Chinese PLA, Clinic Laboratory Department, Beijing 100853, China.
Wei
Yu-Xiang
YX
Zhang
Li-Wen
LW
Yin
Zong-Jian
ZJ
Bai
Jie
J
D000328:Adult; D000368:Aged; D000991:Antithrombins / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006487:Hemostasis; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011517:Prothrombin Time; D012720:Severity of Illness Index
D000991:Antithrombins; D001779:Blood Coagulation Factors; D005340:Fibrinogen