Protein C and D-dimer are related to portal vein thrombosis in patients with liver cirrhosis.
OBJECTIVE
To profile changes of coagulation, anticoagulation and fibrolytic factors associated with liver function failure and portal vein thrombosis (PVT) formation in chronic liver cirrhosis patients.


METHODS
A total of 116 cirrhotic patients admitted to our hospital from June 2006 to October 2008 were included in our study. All patients were classified into two groups: PVT group (31 patients), composed of patients with PVT and a control group (85 patients), including patients without PVT. Platelet, prothrombin time (PT), activated partial prothrombin time (APTT) and fibrinogen were measured. Also, plasma samples from the patients were analyzed for the levels of antithrombin III (AT-III), protein C (PC), protein S (PS), D-dimer, tissue-type plasminogen activator as well as plasminogen activator inhibitor-1. Statistical analyses were carried out to evaluate the correlation of specific variations with the disease status.


RESULTS
In general, the higher Child-Pugh scores, indicating the aggravation of hepatic impairment of the patients, correlated well with the prolonged PT/APTT and increased D-dimer, as well as decreased platelet, fibrinogen, PC and AT-III levels in the serum. Furthermore, we found that the PC, PS and D-dimer levels in PVT patients were 2.32 +/- 0.72 mg/L, 17.14 +/- 3.62 mg/L and 0.99 +/- 0.36 mg/L, respectively, both representing a significant difference compared with those in the control group without PVT. Logistic regression model shows that the odds ratio value of one unit of increase of PC and D-dimer were 0.48 and 15.57.


CONCLUSIONS
Cirrhotic patients displayed dysfunctions in the coagulation, anti-coagulation and fibrolytic systems. The development of PVT in these patients may be independently associated with the decrease of PC, PS and D-dimer. Furthermore, decreasing PC and increasing D-dimer may be risk factors inducing PVT in cirrhotic patients.
Zhang
Donglei
D
Beijing Chaoyang Hospital Affiliate of Capital Medical University, Department of Gastroenterology, Beijing, China. zdlzdl52973@sina.com
Hao
Jianyu
J
Yang
Ning
N
D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011169:Portal Vein; D011486:Protein C / Q000032:analysis*; D017293:Protein S / Q000032:analysis; D011517:Prothrombin Time; D018570:Risk Assessment; D012307:Risk Factors; D020246:Venous Thrombosis / Q000097:blood / Q000209:etiology*
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D011486:Protein C; D017293:Protein S; C036309:fibrin fragment D; D000990:Antithrombin III