Department of Clinical Laboratory, Beijing Jishuitan Hospital, Beijing, China.
Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620982666. doi: 10.1177/1076029620982666.
To evaluate variations in coagulation, fibrinolysis and endothelial marker expression in cirrhotic patients and to explore their clinical value and predictive performance in cirrhotic patients with or without portal vein thrombosis (PVT), we performed a case-control study with 175 cirrhotic patients and 50 healthy individuals. 99 patients had PVT and another 76 patients did not. All participants were evaluated for plasma levels of conventional hemostatic markers. Thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), thrombomodulin (TM), tissue plasminogen activator inhibitor complex (t-PAIC), von Willebrand factor antigen (vWF: Ag) and coagulation factor Ⅷ (FⅧ: c) were also assessed and the ratio of TAT/t-PAIC was calculated. We analyzed differences in these biomarkers among the three groups and constructed receiver operating characteristic (ROC) curves. Patients with PVT exhibited significantly higher TAT and TAT/t-PAIC than cirrhotic patients without PVT (both P < 0.001). Areas under the curve (AUC) of ROC analyses for TAT and TAT/t-PAIC were 0.68 and 0.66, the cut-off levels were 1.55 ng/ml and 0.46, with sensitivities and specificities of 78.79% and 51.32% regarding TAT, 39.8% and 90.79% regarding TAT/t-PAIC. Levels of FⅧ: c and vWF: Ag in patients with PVT were significantly lower than those without PVT (p = 0.026 and p = 0.027, respectively). The AUC, cut-off level, sensitivity and specificity of FⅧ: c were 0.64, 111.1%, 66.67% and 60%, respectively. For vWF: Ag they were 0.61, 429%, 89.66% and 38.71%, respectively. Cirrhotic patients have disorders of coagulation, fibrinolysis and the endothelial system. TAT, TAT/t-PAIC, FⅧ: c and vWF: Ag can be used as potential biomarkers for predicting PVT in cirrhotic patients.
为了评估肝硬化患者凝血、纤溶和内皮标志物表达的变化，并探讨其在伴有或不伴有门静脉血栓形成（PVT）的肝硬化患者中的临床价值和预测性能，我们进行了一项病例对照研究，纳入了 175 例肝硬化患者和 50 名健康对照者。99 例患者存在 PVT，另 76 例患者不存在 PVT。所有参与者均评估了常规止血标志物的血浆水平。还评估了凝血酶-抗凝血酶复合物（TAT）、纤溶酶-α2-纤溶酶抑制剂复合物（PIC）、血栓调节蛋白（TM）、组织型纤溶酶原激活物抑制剂复合物（t-PAIC）、血管性血友病因子抗原（vWF：Ag）和凝血因子Ⅷ（FⅧ：c），并计算了 TAT/t-PAIC 比值。我们分析了三组间这些生物标志物的差异，并构建了受试者工作特征（ROC）曲线。与无 PVT 的肝硬化患者相比，PVT 患者的 TAT 和 TAT/t-PAIC 显著升高（均 P < 0.001）。TAT 和 TAT/t-PAIC 的 ROC 分析曲线下面积（AUC）分别为 0.68 和 0.66，截断值分别为 1.55ng/ml 和 0.46，TAT 的灵敏度和特异性分别为 78.79%和 51.32%，TAT/t-PAIC 的灵敏度和特异性分别为 39.8%和 90.79%。PVT 患者的 FⅧ：c 和 vWF：Ag 水平明显低于无 PVT 患者（分别为 p = 0.026 和 p = 0.027）。FⅧ：c 的 AUC、截断值、灵敏度和特异性分别为 0.64、111.1%、66.67%和 60%，vWF：Ag 的 AUC、截断值、灵敏度和特异性分别为 0.61、429%、89.66%和 38.71%。肝硬化患者存在凝血、纤溶和内皮系统紊乱。TAT、TAT/t-PAIC、FⅧ：c 和 vWF：Ag 可作为预测肝硬化患者 PVT 的潜在生物标志物。
