Basildon and Thurrock University Hospital, Basildon, Essex, United Kingdom.
Adv Med Sci. 2010;55(1):16-21. doi: 10.2478/v10039-010-0018-3.
Liver cirrhosis is associated with number of hematological complications and coagulation disturbances. In view of various haemostatic abnormalities it is surprising that many patients do not bleed spontaneously. Severe coagulopathy of liver disease is more frequently seen in acute liver failure, but still remains important complication of liver cirrhosis and chronic liver failure. Decreased production of blood coagulation factors by the liver plays a key role in altered haemostasis in liver diseases. Altered fragile balance of blood coagulation proteins and infection are associated with both worsening coagulopathy and bleeding risk. Additional haemostatic abnormalities in patients with severe liver diseases are thrombocytopenia, chronic disseminated intravascular coagulation, accelerated fibrinolysis, hypofibrinogenemia and dysfibrinogenemia. In this review we discuss a complicated issue of multiple coagulopathies in patients with advanced liver dysfunction.
肝硬化与多种血液学并发症和凝血障碍有关。鉴于各种止血异常，许多患者没有自发性出血，这令人惊讶。严重的肝疾病凝血功能障碍更常见于急性肝功能衰竭，但仍然是肝硬化和慢性肝功能衰竭的重要并发症。肝脏凝血因子生成减少在肝脏疾病中止血功能改变中起关键作用。凝血蛋白的脆弱平衡改变和感染与凝血功能恶化和出血风险增加有关。严重肝脏疾病患者的其他止血异常包括血小板减少症、慢性弥散性血管内凝血、纤维蛋白溶解加速、低纤维蛋白原血症和异常纤维蛋白原血症。在这篇综述中，我们讨论了晚期肝功能障碍患者多种凝血功能障碍的复杂问题。
