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肝硬化和肿瘤相关性门静脉血栓形成中的止血异常。

Hemostatic abnormalities in cirrhosis and tumor-related portal vein thrombosis.

机构信息

Gastroenterology Department, Bakırkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

出版信息

Clin Appl Thromb Hemost. 2012 Jul;18(4):409-15. doi: 10.1177/1076029611427900. Epub 2011 Dec 13.

Abstract

In order to investigate the relationship between hemostatic abnormalities and portal vein thrombosis (PVT) in hepatocellular carcinoma (HCC), platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time, fibrinogen, d-dimer, fibrinogen degradation products (FDPs), protein C, protein S, antithrombin, plasminogen, antiplasmin, coagulation factors (CFs) V, VII, VIII, IX, XI, and XIII, von Willebrand factor (vWF), prothrombin fragment 1 + 2 (PF 1 + 2), tissue-type plasminogen activator (tPA), and plasminogen activator inhibitor 1 (PAI-1) were studied in patients with HCC, cholangiocarcinoma, and metastatic liver tumors and in cirrhosis patients with or without PVT. Platelet, antithrombin, protein C, plasminogen, and CFs V, VII, IX, XI, and XIII levels of HCC group were found lower and PT, aPTT, thrombin time, vWF, FDPs, PF 1 + 2, tPA, and PAI-1 levels were higher than the control group. Our findings suggested that the abnormalities of coagulation and fibrinolysis systems have some role in provoking thrombosis of portal veins in HCC, in addition to the invasion of portal veins by hepatoma cells.

摘要

为了研究肝肿瘤(HCC)患者止血异常与门静脉血栓形成(PVT)的关系,我们研究了 HCC、胆管癌和转移性肝肿瘤患者以及伴有或不伴有 PVT 的肝硬化患者的血小板、凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、凝血酶时间、纤维蛋白原、D-二聚体、纤维蛋白降解产物(FDPs)、蛋白 C、蛋白 S、抗凝血酶、纤溶酶原、抗纤溶酶、凝血因子(CFs)V、VII、VIII、IX、XI 和 XIII、血管性血友病因子(vWF)、凝血酶原片段 1+2(PF 1+2)、组织型纤溶酶原激活物(tPA)和纤溶酶原激活物抑制剂 1(PAI-1)。结果发现 HCC 组的血小板、抗凝血酶、蛋白 C、纤溶酶原和 CFs V、VII、IX、XI 和 XIII 水平较低,PT、aPTT、凝血酶时间、vWF、FDPs、PF 1+2、tPA 和 PAI-1 水平高于对照组。我们的研究结果表明,除了肝癌细胞侵犯门静脉外,凝血和纤溶系统的异常在 HCC 门静脉血栓形成中也有一定作用。

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