Patrassi G M, Sartori M T, Sgarabotto D, Sturniolo G, Boeri G, Girolami A
Institute of Medical Semeiotics, University of Padua Medical School, Italy.
Res Exp Med (Berl). 1988;188(5):351-6. doi: 10.1007/BF01851203.
Ascitic fluid reinfusion in severe cirrhosis has frequently been associated with intravascular coagulation (DIC). A low-grade DIC has been postulated to be present in liver cirrhosis. PT, APTT, fibrinogen, plasminogen, antiplasmin, fibrin degradation producers (FDP), euglobulin lysis time, tissue plasminogen activator, and fibrinopeptide A were investigated both in the plasma and ascitic fluid of cirrhotic patients before and after the concentration-reinfusion technique. Our results indicate that increased thrombin formation associated with hyperfibrinolysis is present in the plasma of cirrhotic patients. In ascitic fluid very high levels of thrombin and fibrinolysis activation were found. We conclude that (1) a DIC-like picture exists in ascites and (2) after ascites reinfusion procedures, ascitic fluid is the principal factor in the pathogenesis of DIC. During ascitic fluid reinfusion heparin treatment could be used successfully.
严重肝硬化患者腹水性液体回输常与血管内凝血（弥散性血管内凝血，DIC）相关。据推测，肝硬化患者存在低度DIC。在采用浓缩回输技术前后，对肝硬化患者的血浆和腹水性液体中的凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原、纤溶酶原、抗纤溶酶、纤维蛋白降解产物（FDP）、优球蛋白溶解时间、组织纤溶酶原激活物及纤维肽A进行了研究。我们的结果表明，肝硬化患者血浆中存在与高纤溶状态相关的凝血酶生成增加。在腹水性液体中发现了非常高的凝血酶水平及纤溶激活。我们得出结论：（1）腹水中存在类似DIC的表现；（2）腹水回输后，腹水性液体是DIC发病机制中的主要因素。在腹水性液体回输期间，肝素治疗可成功应用。
