Green G, Poller L, Thomson J M, Dymock I W
J Clin Pathol. 1976 Nov;29(11):971-5. doi: 10.1136/jcp.29.11.971.
Factor VII levels have been measured in 100 patients with liver disease following parenteral vitamin K1 therapy. There was good agreement between specific factor VII measurements and the one-stage prothrombin time apart from six patients with compensated cirrhosis in whom the prothrombin time was prolonged despite the presence of normal factor VII levels. A mean activity of 58% was found in patients with cirrhosis. Cirrhotic patients with features of hepatic decompensation had a significantly lower mean level of activity (40%) than the "contrast" patients with surgical obstruction of the major bile ducts (93%). Patients with chronic active liver disease had moderate depression of factor VII levels and those with non-cirrhotic liver damage had mean activities similar to the contrast group. Factor VII levels could not be correlated with BSP retention but there was a correlation with serum albumin concentration. It is concluded that the prothrombin time using Quick test with a standardized thromboplastin showing good sensitivity to factor VII, eg, the Manchester reagent (BCT), provides a reliable index of coagulability in chronic liver disease, and specific factor VII assays are not indicated.
对100例接受胃肠外维生素K1治疗的肝病患者测定了凝血因子VII水平。除6例代偿期肝硬化患者外，凝血因子VII的特异性测定结果与一期凝血酶原时间之间具有良好的一致性，这6例患者尽管凝血因子VII水平正常，但凝血酶原时间却延长。肝硬化患者的平均活性为58%。具有肝失代偿特征的肝硬化患者的平均活性水平（40%）显著低于主要胆管手术梗阻的“对照”患者（93%）。慢性活动性肝病患者的凝血因子VII水平有中度降低，非肝硬化性肝损伤患者的平均活性与对照组相似。凝血因子VII水平与磺溴酞钠潴留无相关性，但与血清白蛋白浓度相关。结论是，使用对凝血因子VII具有良好敏感性的标准化凝血活酶（如曼彻斯特试剂（BCT））进行奎克试验的凝血酶原时间，可提供慢性肝病中可靠的凝血指标，无需进行凝血因子VII的特异性检测。
