[肝硬化患者血液凝固抑制剂水平的变化。33例患者的前瞻性研究]

[Changes in levels of blood coagulation inhibitors in cirrhosis. Prospective study in 33 patients].

作者信息

Dumontier I, Alhenc-Gelas M, Chatellier G, Brenet P, Aiach M, Petite J P

机构信息

Service d'Hépato-Gastroentérologie, Hôpital Broussais, Paris.

出版信息

Gastroenterol Clin Biol. 1992;16(2):120-5.

PMID:1314744

Abstract

The variations of the main plasma inhibitors of coagulation were prospectively studied in 33 cirrhotic patients, of which 9 presented with hepatocellular carcinoma, 5 of those associated with portal vein thrombosis. The mean prothrombin index was 49 +/- 16 percent. All plasma values of inhibitors were diminished, but to varied degrees: the mean values were: protein C (PC): 33 +/- 15 percent, antithrombin III (AT III): 50 +/- 23 percent, total protein S (PST): 67 +/- 20 percent. The more severe the cirrhosis, the more decreased were the values of antithrombin II and protein C. According to Child classes A, B, and C, antithrombin III plasma values were 64 +/- 20, 50 +/- 21 and 26 +/- 11 percent and protein C values were 43 +/- 16, 32 +/- 8 and 19 +/- 9 percent, respectively. We were able to define expected plasma values of the plasma inhibitors as a function of coagulation factors during cirrhosis; AT III (percent) = 1.16 x factor II (percent) - 7.85; PC (percent) = 0.49 x AT III (percent) + 8.96; PC (percent) = 0.55 x factor II (percent) + 5.55; PST (percent) = 0.76 x factor II (percent) + 28.74. However those equations cannot be extrapolated to patients presenting with cirrhosis complicated with portal thrombosis.

摘要

对33例肝硬化患者的主要血浆凝血抑制剂变化进行了前瞻性研究，其中9例患有肝细胞癌，其中5例伴有门静脉血栓形成。凝血酶原指数平均值为49±16%。所有抑制剂的血浆值均降低，但程度不同：平均值分别为：蛋白C（PC）：33±15%，抗凝血酶III（AT III）：50±23%，总蛋白S（PST）：67±20%。肝硬化越严重，抗凝血酶II和蛋白C的值降低越明显。根据Child分级A、B和C，抗凝血酶III血浆值分别为64±20%、50±21%和26±11%，蛋白C值分别为43±16%、32±8%和19±9%。我们能够确定肝硬化期间血浆抑制剂的预期血浆值与凝血因子的关系；AT III（%）=1.16×因子II（%）-7.85；PC（%）=0.49×AT III（%）+8.96；PC（%）=0.55×因子II（%）+5.55；PST（%）=0.76×因子II（%）+28.74。然而，这些方程不能外推到伴有门静脉血栓形成的肝硬化患者。