Jedrychowski A, Hillenbrand P, Ajdukiewicz A B, Parbhoo S P, Sherlock S
Br Med J. 1973 Mar 17;1(5854):640-2. doi: 10.1136/bmj.1.5854.640.
The fibrinolytic system was studied in primary biliary cirrhosis (16 patients) and large bile duct obstruction (10 patients, nine of whom had carcinoma). Plasma fibrinolysis (plasminogen activator activity) was decreased and fibrinogen increased in both groups of patients, particularly in those with large duct obstruction. These changes were related to the degree of cholestasis. Plasminogen activator activity was inversely related to serum triglyceride levels in patients with primary biliary cirrhosis. Urokinase inhibitors were decreased in both groups and antiplasmins increased in patients with large duct obstruction; fibrin/fibrinogen degradation products were normal in primary biliary cirrhosis and moderately increased in large duct obstruction. None of these fibrinolytic indices was related to the degree of cholestasis. Fibrinolytic activity and fibrinogen returned almost to normal levels after palliative surgery in the three patients with large duct obstruction who were studied. The decreased plasma fibrinolysis and increased fibrinogen may be due to altered lipid metabolism in cholestatic jaundice. In patients undergoing surgery for large duct obstruction there may be an increased risk of thrombosis.
对原发性胆汁性肝硬化患者（16例）和大胆管梗阻患者（10例，其中9例患有癌症）的纤溶系统进行了研究。两组患者的血浆纤溶（纤溶酶原激活物活性）均降低，纤维蛋白原增加，尤其是大胆管梗阻患者。这些变化与胆汁淤积程度有关。在原发性胆汁性肝硬化患者中，纤溶酶原激活物活性与血清甘油三酯水平呈负相关。两组患者的尿激酶抑制剂均减少，大胆管梗阻患者的抗纤溶酶增加；原发性胆汁性肝硬化患者的纤维蛋白/纤维蛋白原降解产物正常，大胆管梗阻患者中度增加。这些纤溶指标均与胆汁淤积程度无关。在接受研究的3例大胆管梗阻患者中，姑息性手术后纤溶活性和纤维蛋白原几乎恢复到正常水平。血浆纤溶降低和纤维蛋白原增加可能是由于胆汁淤积性黄疸时脂质代谢改变所致。对于接受大胆管梗阻手术的患者，血栓形成风险可能增加。
