De Caterina M, Tarantino G, Farina C, Arena A, di Maro G, Esposito P, Scopacasa F
Department of Biochemistry and Medical Biotechnologies, Medical School, University of Naples Federico II, Italy.
Haemostasis. 1993 Jul-Aug;23(4):229-35. doi: 10.1159/000216879.
Liver cirrhosis leads to a protido-synthetic impairment that alters the levels of blood clotting factors and haemostasis. The aim of this study was to assess the alterations of haemostatic parameters in the evolution of liver cirrhosis scored according to Child's classification, with Pugh's modifications. Thirty-seven patients suffering from alcoholic and non-alcoholic liver cirrhosis, representing stages A5, A6, B7, B8 and C10, were tested for the main blood clotting parameters, i.e. prothrombin time, factor VII, partial activated thromboplastin time, fibrinogen, plasminogen, alpha 2-antiplasmin and physiological inhibitors [antithrombin III (ATIII), protein C (PC), protein S (PS)]. No variations were observed between substages A5 and A6 in any of the parameters, except for coagulation inhibitor levels. Most parameters showed a progressive decrease in stages B and C of the disease. The most significant alterations were found in the physiological coagulation inhibitors, with a sharper decrease in PC and AT III level and a lesser decrease in the level of PS through stages A5 and B8: this evidence could assume an important biological and diagnostic significance.
肝硬化会导致蛋白质合成功能受损，进而改变血液凝固因子水平和止血功能。本研究旨在评估根据Child分级并经Pugh修正的肝硬化病程中止血参数的变化。对37例酒精性和非酒精性肝硬化患者（分别代表A5、A6、B7、B8和C10期）进行了主要血液凝固参数检测，即凝血酶原时间、因子VII、部分活化凝血活酶时间、纤维蛋白原、纤溶酶原、α2-抗纤溶酶和生理性抑制剂[抗凝血酶III（ATIII）、蛋白C（PC）、蛋白S（PS）]。除凝血抑制剂水平外，A5期和A6期各参数均未观察到差异。大多数参数在疾病的B期和C期呈逐渐下降趋势。生理凝血抑制剂的变化最为显著，在A5期至B8期，PC和AT III水平下降更为明显，而PS水平下降程度较小：这一证据可能具有重要的生物学和诊断意义。
