Knot E, Ten Cate J W, Drijfhout H R, Kahlé L H, Tytgat G N
J Clin Pathol. 1984 May;37(5):523-30. doi: 10.1136/jcp.37.5.523.
Liver diseases are associated with complex haemostasis defects, in which platelets, coagulation, and fibrinolysis may all be affected. The low plasma concentrations of clotting factors often found can be the result of many changes such as impaired synthesis, increased catabolism due to intravascular coagulation, or alternate distribution. In this study, we investigated the metabolism of purified human antithrombin III(AT III) labelled with 125I in 25 patients with histologically established liver disease and in nine control subjects. The results showed that, in general, low plasma concentrations of AT III in liver cirrhosis are not due to consumption in the central compartment but rather to altered transcapillary flux ratio. Such altered transcapillary flux ratios may already exist even with normal plasma AT III concentrations. Altered ratios are not only found for coagulation proteins but also for albumin and thus may be a general phenomenon of liver disease. In micronodular cirrhosis the alpha phase, the transcapillary efflux (k1, 2) and influx (k2, 1) were significantly increased compared with the normal subjects.
肝脏疾病与复杂的止血缺陷有关，其中血小板、凝血和纤溶都可能受到影响。经常发现的凝血因子血浆浓度低可能是多种变化的结果，如合成受损、血管内凝血导致的分解代谢增加或分布改变。在本研究中，我们调查了25例经组织学确诊的肝病患者和9名对照受试者中用125I标记的纯化人抗凝血酶III（AT III）的代谢情况。结果表明，一般来说，肝硬化患者血浆AT III浓度低并非由于中央室的消耗，而是由于跨毛细血管通量率改变。即使血浆AT III浓度正常，这种改变的跨毛细血管通量率也可能已经存在。不仅凝血蛋白存在改变的比率，白蛋白也是如此，因此这可能是肝病的普遍现象。在小结节性肝硬化的α期，与正常受试者相比，跨毛细血管流出（k1,2）和流入（k2,1）显著增加。
