Ohmoto K, Yamamoto S, Ideguchi S, Yamamoto R, Takatori K, Ohumi T, Hino K, Hirano Y
Department of Medicine, Kawasaki Medical School.
Nihon Shokakibyo Gakkai Zasshi. 1990 Sep;87(9):1837-45.
Thrombin-antithrombin III complex (TAT) and Plasmin-alpha 2 plasmin inhibitor complex (PIC) were examined in fifty two cases of various chronic liver diseases. TAT was significantly elevated in cases of hepatocellular carcinoma (HCC), but PIC did not show significant changes in any chronic liver diseases. Elevations of TAT and PIC were seen in cases of HCC accompanied by tumor enlargement and extensive tumor thrombosis. In cases of HCC undergoing transcatheter arterial embolization (TAE), TAT and PIC increased on the next day after TAE, and tended to recover with time, returning to almost normal at fourth week. Prolongation of prothrombin time, elevation of FDP and positive FM test were noted more often in liver cirrhosis with disseminated intravascular coagulation (DIC) than in severe liver dysfunction without DIC. Of five cases confirmed as DIC, only three cases were diagnosed as DIC by DIC score. On the other hand, TAT and PIC were significantly elevated in DIC cases. Especially, TAT exceeded 30 ng/ml in all DIC cases. TAT was regarded to be useful for the diagnosis of DIC in severe liver dysfunction.
在52例各种慢性肝病患者中检测了凝血酶 - 抗凝血酶III复合物(TAT)和纤溶酶 - α2纤溶酶抑制物复合物(PIC)。肝细胞癌(HCC)患者的TAT显著升高,但在任何慢性肝病中PIC均未显示出显著变化。在伴有肿瘤增大和广泛肿瘤血栓形成的HCC患者中可见TAT和PIC升高。在接受经导管动脉栓塞术(TAE)的HCC患者中,TAE术后第二天TAT和PIC升高,并随时间趋于恢复,在第四周时几乎恢复正常。与无弥散性血管内凝血(DIC)的严重肝功能不全相比,伴有DIC的肝硬化患者更常出现凝血酶原时间延长、纤维蛋白降解产物(FDP)升高和血浆鱼精蛋白副凝试验(FM试验)阳性。在确诊为DIC的5例患者中,只有3例通过DIC评分被诊断为DIC。另一方面,DIC患者的TAT和PIC显著升高。特别是,所有DIC患者的TAT均超过30 ng/ml。TAT被认为对严重肝功能不全患者的DIC诊断有用。