Michalska Kinga, Szaflarska-Popławska Anna, Dymek Grazyna, Kotschy Maria
Katedra i Klinika Pediatrii Alergologii i Gastroenterologii Akademii Medycznej w Bydgoszczy.
Pol Merkur Lekarski. 2004 Oct;17(100):316-20.
Fibrinolysis is involved in numerous systemic processes, including inflammation and tissue remodeling. Up to date researchers focused on hemostasis problems in patients with cirrhosis. There are little data about fibrynolysis in patient with chronic viral hepatitis. The aim of the study was to evaluate selected fibrinolytic parameters in children with chronic B or C hepatitis.
98 children aged 4 to 17 years (27F, 71M) with histopatologically confirmed chronic B or C hepatitis were included in the study. The control group consisted of 51 children median aged 12.5 years (25F, 26M) on strict gluten-free diet at least 5 years because of coeliac disease. In platelet-poor plasma obtained from all children selected fibrinolytic parameters were determined: fibrinogen level (Hemolab Fibrinomat bioMerieux S.A.), plasminogen activity (Berichrom-Plasminogen Behring), tissue plasminogen activator antigen level (t-PA) (Imulyse t-PA Biopool), plasminogen activator inhibitor 1 level (PAI-1) (Imulyse PAI-1 Biopool), plasmin-alpha2-antiplasmin complex level (PAP) (Enzygnost PAP micro) oraz D-dimer level (Vidas D-Dimer bioMérieux S.A.).
In children with chronic viral hepatitis statistically significant lower fibrinogen level (p<0.03) and PAI-1 level (p<0.0001) and higher t-PA level (p<0.0001) in comparison to control group were found. In children with chronic B hepatitis significant lower PAI-1 level (p<0.0001) and higher PAP level (p<0.0001) than in controls were observed. In children with chronic C hepatitis statistically significant lower PAI-1 level (p<0.0001) and fibrinogen level (p<0.005) and higher PAP level (p<0.0001) and t-PA level (p<0.03) were found. There were no differences in fibrinolytic parameters levels between children with B and C hepatitis.
Activation of fibrinolysis, especially plasminogenesis seems to be present in children with chronic viral hepatitis independently on type of hepatotropic virus.
纤维蛋白溶解参与众多全身过程,包括炎症和组织重塑。到目前为止,研究人员主要关注肝硬化患者的止血问题。关于慢性病毒性肝炎患者纤维蛋白溶解的资料很少。本研究的目的是评估慢性B型或C型肝炎患儿的某些纤维蛋白溶解参数。
98名年龄在4至17岁(27名女性,71名男性)、经组织病理学确诊为慢性B型或C型肝炎的儿童纳入研究。对照组由51名儿童组成,由于患有乳糜泻,他们至少5年来一直严格遵循无麸质饮食,年龄中位数为12.5岁(25名女性,26名男性)。从所有儿童获得的乏血小板血浆中测定选定的纤维蛋白溶解参数:纤维蛋白原水平(Hemolab Fibrinomat bioMerieux S.A.)、纤溶酶原活性(Berichrom - Plasminogen Behring)、组织纤溶酶原激活物抗原水平(t - PA)(Imulyse t - PA Biopool)、纤溶酶原激活物抑制剂1水平(PAI - 1)(Imulyse PAI - 1 Biopool)、纤溶酶 - α2 - 抗纤溶酶复合物水平(PAP)(Enzygnost PAP micro)以及D - 二聚体水平(Vidas D - Dimer bioMérieux S.A.)。
与对照组相比,慢性病毒性肝炎患儿的纤维蛋白原水平(p<0.03)和PAI - 1水平(p<0.0001)在统计学上显著降低,t - PA水平(p<0.0001)显著升高。与对照组相比,慢性B型肝炎患儿的PAI - 1水平(p<0.0001)显著降低,PAP水平(p<0.0001)显著升高。在慢性C型肝炎患儿中,发现PAI - 1水平(p<0.0001)和纤维蛋白原水平(p<0.005)在统计学上显著降低,PAP水平(p<0.0001)和t - PA水平(p<0.03)显著升高。B型和C型肝炎患儿的纤维蛋白溶解参数水平没有差异。
慢性病毒性肝炎患儿中似乎存在纤维蛋白溶解的激活,尤其是纤溶酶生成,这与嗜肝病毒的类型无关。