Ritter D M, Owen C A, Bowie E J, Rettke S R, Cole T L, Taswell H F, Ilstrup D M, Wiesner R H, Krom R A
Department of Anesthesiology, Emory University Hospital, Atlanta, Georgia.
Mayo Clin Proc. 1989 Feb;64(2):216-23. doi: 10.1016/s0025-6196(12)65676-6.
We retrospectively reviewed the results of preoperative hematology-coagulation studies in 66 patients who underwent orthotopic liver transplantation-24 with the primary diagnosis of chronic active hepatitis (CAH), 22 with primary sclerosing cholangitis (PSC), and 20 with primary biliary cirrhosis (PBC). The mean prothrombin time was above normal in all three diagnostic groups, patients with CAH having the highest values. The mean activated partial thromboplastin time was normal in patients with PSC or PBC but elevated in those with CAH. Fibrinogen levels were above normal in patients with PBC but decreased in 1 patient (5%) with PSC and 10 (42%) with CAH. Mean platelet counts were below normal in 68% and 55% of patients with PSC and PBC, respectively, but in 96% of those with CAH. The mean Ivy bleeding time was normal in patients with PSC or PBC but prolonged in those with CAH. Patients with PSC or PBC had normal mean activity levels of factors II, V, VII, IX, and X, whereas those with CAH had below normal mean values for factors II and VII. The antithrombin III activity level was normal in patients with PSC or PBC but reduced in those with CAH. Thus, patients with CAH have a greater derangement in results of clotting studies in comparison with those who have PSC or PBC, but the use of blood did not differ among the three diagnostic groups.
我们回顾性分析了66例接受原位肝移植患者术前血液学凝血检查的结果，其中24例原发性诊断为慢性活动性肝炎（CAH），22例原发性硬化性胆管炎（PSC），20例原发性胆汁性肝硬化（PBC）。所有三个诊断组的平均凝血酶原时间均高于正常，CAH患者的值最高。PSC或PBC患者的平均活化部分凝血活酶时间正常，但CAH患者升高。PBC患者的纤维蛋白原水平高于正常，但1例（5%）PSC患者和10例（42%）CAH患者降低。PSC和PBC患者的平均血小板计数分别有68%和55%低于正常，但CAH患者有96%低于正常。PSC或PBC患者的平均Ivy出血时间正常，但CAH患者延长。PSC或PBC患者的因子II、V、VII、IX和X的平均活性水平正常，而CAH患者的因子II和VII平均水平低于正常。PSC或PBC患者的抗凝血酶III活性水平正常，但CAH患者降低。因此，与PSC或PBC患者相比，CAH患者的凝血检查结果紊乱更严重，但三个诊断组的用血情况无差异。
