Baele G, Rasquin K, Barbier F
Am J Gastroenterol. 1986 Jun;81(6):440-3.
Ascitic fluid samples from 14 subjects with liver cirrhosis and from 13 patients with malignancy were investigated. Activated FX was present in ascitic fluid in small quantities with a mean value of 8.7 10(-3) IU/ml. The mean thrombin activity was 70.8 10(-3) IU/ml and the mean plasmin activity was 449.6 10(-3) CU/ml. High levels of fibrin/fibrinogen degradation products (mean 75.4 micrograms/ml) and of antithrombin III (mean 43.4%) were found. No statistically significant differences between values in liver cirrhosis and in malignancy were found. In 15 of 17 experiments 10-fold concentrated ascitic fluid caused irreversible platelet aggregation and [14C] serotonin release of normal platelet-rich plasma similar to collagen. The aggregating effect disappeared after addition of collagenase. These results do not support the concept that the coagulopathy after peritoneovenous shunting is a result of direct and rapid intravenous infusion of procoagulant substances. They rather point to a central role of collagen present in ascitic fluid.
对14例肝硬化患者和13例恶性肿瘤患者的腹水样本进行了研究。腹水中存在少量活化的凝血因子X，平均值为8.7×10⁻³ IU/ml。凝血酶平均活性为70.8×10⁻³ IU/ml，纤溶酶平均活性为449.6×10⁻³ CU/ml。发现纤维蛋白/纤维蛋白原降解产物水平较高（平均75.4微克/毫升），抗凝血酶III水平较高（平均43.4%）。肝硬化患者和恶性肿瘤患者的值之间未发现统计学上的显著差异。在17个实验中的15个实验中，10倍浓缩的腹水导致正常富含血小板血浆发生不可逆的血小板聚集和[¹⁴C]血清素释放，类似于胶原蛋白的作用。加入胶原酶后，聚集效应消失。这些结果不支持腹膜静脉分流术后凝血病是由于促凝血物质直接快速静脉输注所致的观点。它们更表明腹水中存在的胶原蛋白起核心作用。
