Audhuy B, Doffoel M, Wiesel M L, Hemmendinger S, Cazenave J P, Bockel R
Ann Gastroenterol Hepatol (Paris). 1984 Jul-Sep;20(4):177-82.
In order to assess the true incidence of haemostatic disorders in cirrhotic gastro-intestinal haemorrhage, a comparative prospective study of primary haemostasis, coagulation and fibrinolysis was carried out in 37 patients distributed into two groups: cirrhotics with gastro-oesophageal varices that had never bled (Group A = 22), and cirrhotics who had had an intestinal bleed from "ruptured" gastro-oesophageal varices (Group B = 15). Combination of thrombocytopenia (less than 100 10(9)/l) and a bleeding time greater than 8 mn was more frequent in Group B (80%) than in Group A (45%) (p = less than 0.05). On the other hand, no significant difference between the two groups was found in the activated cephalin time, thrombin time, prothrombin complex factors (II, V, VII-X), fibrinogen, antithrombin III, Factor VIII complex factors, FDP levels or plasminogen. In conclusion, these results suggest that disorders of primary haemostasis may be involved in bleeding from gastro-intestinal varices in cirrhosis. However, coagulation disorders and anomalies of fibrinolysis would not seem to play a determining role.
为评估肝硬化患者胃肠道出血时止血障碍的真实发生率，对37例患者进行了一项关于初级止血、凝血和纤维蛋白溶解的前瞻性对比研究，这些患者分为两组：从未发生过出血的肝硬化食管胃静脉曲张患者（A组=22例），以及因“破裂”食管胃静脉曲张而发生过肠道出血的肝硬化患者（B组=15例）。B组血小板减少（低于100×10⁹/L）且出血时间大于8分钟的情况（80%）比A组（45%）更常见（p<0.05）。另一方面，两组在活化部分凝血活酶时间、凝血酶时间、凝血酶原复合因子（II、V、VII - X）、纤维蛋白原、抗凝血酶III、因子VIII复合因子、纤维蛋白降解产物水平或纤溶酶原方面未发现显著差异。总之，这些结果表明初级止血障碍可能与肝硬化患者胃肠道静脉曲张出血有关。然而，凝血障碍和纤维蛋白溶解异常似乎不起决定性作用。
