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慢性肝病中的凝血酶生成——一项初步研究。

Thrombin Generation in Chronic Liver Diseases-A Pilot Study.

作者信息

Vecerzan Liliana, Olteanu Ariela, Maniu Ionela, Boicean Adrian, Cipăian Călin Remus, Dura Horaţiu, Fleacă Sorin Radu, Mihăilă Romeo Gabriel

机构信息

Faculty of Medicine, Romania Lucian Blaga University of Sibiu, 550024 Sibiu, Romania.

Clinical Laboratory, Emergency County Clinical Hospital Sibiu, 550245 Sibiu, Romania.

出版信息

Healthcare (Basel). 2021 May 8;9(5):550. doi: 10.3390/healthcare9050550.

Abstract

The knowledge about coagulation disorders in patients with chronic liver disease changed in the last decade. The aim of this study was to analyze the parameters of thrombin generation in patients with chronic liver disease, as they are the most appropriate biomarkers to explore coagulation. (1) Background: The knowledge about coagulation disorders in patients with chronic liver disease changed in the last decade. The study of thrombin generation in patients with chronic liver disease provides a much more accurate assessment of the coagulation cascade; (2) Methods: This study is a prospective observational pilot study on hospitalized patients with chronic liver diseases that analyzed thrombin generation performed from their platelet-poor plasma versus that of control subjects. We analyzed a group of 59 patients with chronic liver disease and 62 control subjects; (3) Results: Thrombin generation was lower in hepatitis and cirrhosis patients compared to controls and decreases as the disease progressed. Lag time was higher in ethanolic etiology compared to the control group. Peak thrombin and endogenous thrombin potential were shorter in all etiologies when compared to the control group. The velocity index was significantly lower in HCV hepatopathies, ethanolic, and mixed etiology when compared with normal individuals; (4) Conclusions: Given the variability of thrombin generation in patients with chronic liver disease, its assay could serve to identify patients with high thrombotic and hemorrhagic risk and establish personalized conduct toward them.

摘要

在过去十年中,慢性肝病患者凝血障碍方面的知识发生了变化。本研究的目的是分析慢性肝病患者的凝血酶生成参数,因为它们是探索凝血最恰当的生物标志物。(1)背景:在过去十年中,慢性肝病患者凝血障碍方面的知识发生了变化。对慢性肝病患者凝血酶生成的研究能更准确地评估凝血级联反应;(2)方法:本研究是一项针对住院慢性肝病患者的前瞻性观察性初步研究,分析了从其乏血小板血浆中检测的凝血酶生成情况,并与对照组进行比较。我们分析了59例慢性肝病患者和62例对照者;(3)结果:与对照组相比,肝炎和肝硬化患者的凝血酶生成较低,且随着疾病进展而降低。乙醇性病因患者的滞后时间高于对照组。与对照组相比,所有病因患者的凝血酶峰值和内源性凝血酶潜力均较短。与正常个体相比,丙型肝炎、乙醇性及混合性病因患者的速度指数显著较低;(4)结论:鉴于慢性肝病患者凝血酶生成的变异性,其检测可用于识别高血栓形成和出血风险的患者,并针对他们制定个性化治疗方案。

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