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Hemostatic changes in patients with liver cirrhosis
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|July 2, 1999
Summary
This study reveals that liver cirrhosis severity directly correlates with hemostatic changes, including coagulation and fibrinolytic activity. Activated partial thromboplastin time is a key indicator of liver damage and altered hemostasis in cirrhosis patients.
Area of Science:
- Hepatology
- Hematology
- Clinical Biochemistry
Background:
- Hemostatic alterations in liver disease are complex and poorly understood.
- A comprehensive evaluation of hemostatic parameters across different cirrhosis severity levels in Taiwan was lacking.
Purpose of the Study:
- To investigate the relationship between the severity of liver cirrhosis and various hemostatic parameters.
- To identify key indicators of hemostatic dysfunction in cirrhotic patients.
Main Methods:
- Evaluated 51 cirrhosis patients (Child-Pugh A, B, C) and 33 controls using extensive hemostatic tests.
- Included coagulation assays (aPTT, PT, TT), bleeding time, factor VIII, antithrombin, fibrinogen, fibrinolysis markers (tPA, PAI-1, FDPs, D-dimer), and platelet counts.
Main Results:
- Progressive decreases in plasminogen, antithrombin, and platelets observed with increasing cirrhosis severity (A to C).
- Progressive increases in Factor VIII, aPTT, PT, bleeding time, D-dimer, and FDPs correlated with cirrhosis severity.
- Tissue plasminogen activator (tPA) increased progressively with cirrhosis severity, while overall fibrinolytic response to venous occlusion remained unchanged.
Conclusions:
- A strong correlation exists between cirrhosis severity and hemostatic changes, encompassing both coagulation and fibrinolysis.
- Activated partial thromboplastin time (aPTT) is a more sensitive marker of liver damage and hemostatic changes than bleeding time or thrombin time.
- Effective treatment for cirrhotic bleeding requires addressing both coagulation defects and elevated fibrinolytic activity.