Shimazu C, Fukuda T, Yugeta N, Yasuda K, Wakasugi K, Tahara C, Miyajima Y, Kazama M
Central Clinical Laboratory, Teikyo University Hospital, Tokyo.
Rinsho Byori. 1991 Mar;39(3):295-301.
We examined the hemostatic abnormality of liver disease using hemostatic molecular markers, i.e. TAT, FPA and SFMC for coagulation, B beta 15-42, FDP, D dimer and PIC for fibrinolysis, t-PA and TM for vessel wall. The molecular markers for coagulation were generally increased in cases of liver disease, which was most sensitively reflected by FPA. On the other hand, it was postulated that SFMC was a marker reflecting the complication of DIC in these cases. Hyperfibrinolysis of liver disease was sensitively reflected by the increase of B beta 15-42, and an occasional increase of SFMC or FDP was thought to indicate the complication of DIC in these cases. A high correlation was found between t-PA and TM. It was postulated that the increase of the both markers in liver disease was due to deteriorated clearance by liver dysfunction, although TM is regarded as a marker reflecting endothelial injury. It was expected that visualization of hemostatic disorder of liver disease was made practical with the use of radar chart of these molecular markers.
我们使用止血分子标志物,即凝血相关的凝血酶 - 抗凝血酶复合物(TAT)、纤维蛋白肽A(FPA)和可溶性纤维蛋白单体复合物(SFMC),纤溶相关的Bβ15 - 42、纤维蛋白降解产物(FDP)、D - 二聚体和纤溶酶 - 抗纤溶酶复合物(PIC),以及血管壁相关的组织型纤溶酶原激活物(t - PA)和血栓调节蛋白(TM),来研究肝脏疾病的止血异常情况。肝脏疾病患者中凝血相关的分子标志物通常会升高,其中FPA对此反映最为敏感。另一方面,推测SFMC是反映这些病例中弥散性血管内凝血(DIC)并发症的标志物。肝脏疾病的高纤溶状态通过Bβ15 - 42的升高得以敏感反映,偶尔SFMC或FDP的升高被认为提示这些病例中存在DIC并发症。发现t - PA和TM之间存在高度相关性。尽管TM被视为反映内皮损伤的标志物,但推测肝脏疾病中这两种标志物的升高是由于肝功能障碍导致清除功能恶化所致。期望通过这些分子标志物的雷达图来实现肝脏疾病止血紊乱的可视化。