Vecerzan Liliana, Maniu Ionela, Cioca Gabriela
Pharmacology, Emergency Military Clinical Hospital, Sibiu, ROU.
Faculty of Medicine, Lucian Blaga University, Sibiu, ROU.
Cureus. 2024 Oct 13;16(10):e71376. doi: 10.7759/cureus.71376. eCollection 2024 Oct.
Hepatic stellate cells (HSC) are recruited to the site of injury in the liver tissue repair mechanism, and the changes HSC undergo reflect paracrine stimulation by all cell types (sinusoidal endothelial cells, Kupffer cells, hepatocytes, platelets, and leukocytes). This study aimed to analyse a possible correlation between the degree of liver fibrosis and thrombin generation in patients with chronic liver diseases. Background Coagulation disorders in patients with chronic liver disease continue to challenge clinicians. A more accurate assessment of the coagulation cascade is provided by investigating thrombin production in individuals with chronic liver disease with varying degrees of fibrosis. Methods This prospective observational pilot study was done on hospitalized patients with chronic liver diseases. Thrombin generation from their platelet-poor plasma was studied and the degree of liver fibrosis assessed by transient elastography versus that of control subjects. Results The peak thrombin is significantly higher in those with severe liver stiffness (F3) than in those with more advanced fibrosis/liver cirrhosis (F4). Also, the total concentration of thrombin formed in the time interval (area under the curve (AUC)) and velocity index (VI) is higher in those with F3 than those with F4. Conclusion Thrombin generation decreases with the progression of liver fibrosis.
肝星状细胞（HSC）在肝组织修复机制中被募集到损伤部位，HSC所经历的变化反映了所有细胞类型（窦状内皮细胞、库普弗细胞、肝细胞、血小板和白细胞）的旁分泌刺激。本研究旨在分析慢性肝病患者肝纤维化程度与凝血酶生成之间的可能相关性。背景 慢性肝病患者的凝血功能障碍仍然是临床医生面临的挑战。通过研究不同程度纤维化的慢性肝病患者的凝血酶生成情况，可以更准确地评估凝血级联反应。方法 对住院的慢性肝病患者进行了这项前瞻性观察性试点研究。研究了他们的乏血小板血浆中的凝血酶生成情况，并通过瞬时弹性成像评估肝纤维化程度，与对照组进行比较。结果 严重肝硬度（F3）患者的凝血酶峰值明显高于纤维化/肝硬化更严重（F4）的患者。此外，F3患者在时间间隔内形成的凝血酶总浓度（曲线下面积（AUC））和速度指数（VI）高于F4患者。结论 凝血酶生成随着肝纤维化的进展而降低。
