[凝血试验在暴发性肝衰竭中的意义]

[The significance of blood coagulation test in fulminant hepatic failure].

作者信息

Kawamura A, Meguro J, Kukita K, Yonekawa M, Imai K, Kobayashi N, Kawamura K, Kasai M

机构信息

Sapporo Hokuyu Hospital, Artificial Organ & Transplantation Hospital.

出版信息

Hokkaido Igaku Zasshi. 1988 Sep;63(5):805-10.

PMID:3240924

Abstract

We treated 12 cases of fulminant hepatic failure with plasma exchange, cryofiltration and hemodialysis. Five cases were survived and 7 cases died. The liver volume measured by volus CT on admission was about 1106 ml in survived cases, and was about 457 ml in death cases. In cases which liver volume was under 600 ml, these prognoses were miserable. AT-III, PT and HPT activities were well correlated with liver volume (r = 0.85) and these activities were good indicator to treat the fulminant hepatic failure. The measurement of FBG and APTT were also useful for the estimation of the prognosis. But they were not becoming of indicator to treatment. We have no expectation to prognosis of the cases which PT, HPT and AT-III were under 15%, 10%, and 25%, respectively.

摘要

我们采用血浆置换、冷滤过和血液透析治疗了12例暴发性肝衰竭患者。5例存活，7例死亡。存活患者入院时通过容积CT测量的肝脏体积约为1106毫升，死亡患者约为457毫升。肝脏体积小于600毫升的患者，预后较差。抗凝血酶III（AT-III）、凝血酶原时间（PT）和肝促凝血酶原激酶试验（HPT）活性与肝脏体积密切相关（r = 0.85），这些活性是治疗暴发性肝衰竭的良好指标。纤维蛋白原（FBG）和活化部分凝血活酶时间（APTT）的测定对预后评估也有帮助。但它们并非治疗指标。对于PT、HPT和AT-III分别低于15%、10%和25%的患者，我们对其预后不抱期望。