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肝脏对控制凝血起重要作用,肝病患者中检出止血有问题者约75%.凝血异常是基于活化的凝血蛋白及其抑制物之肝内合成和清除间的平衡,是否存在异常纤维蛋白原血症、血小板减少、血小板功能异常及弥散性血管内凝血(DIC).一些患者出现瘀点、瘀斑或鼻衄,但多数无症状,或仅于静脉穿刺或肝活检后出血.然而出血也可以危及生命,患者可能死于静脉曲张破裂出血或DIC.可以通过功能活性测定,即个体的生物学测定,或针对特异抗原之免疫测定来检测凝血蛋白.正常情况下,功能测定与免疫测定密切相关.凝血蛋白的肝脏合成一般认为,除von Willebrand因子(下称
The liver plays an important role in controlling clotting, with about 75% of patients with hepatic bleeding who have a detectable hemostasis.The coagulation abnormalities are based on the balance between intrahepatic synthesis and clearance of activated coagulation proteins and their inhibitors, the presence or absence of abnormal fibrinogen blood Symptoms, thrombocytopenia, impaired platelet function, and disseminated intravascular coagulation (DIC). Some patients have petechia, ecchymoses, or epistaxis, but most are asymptomatic, or only bleed after venipuncture or liver biopsy. However, bleeding is also possible Life-threatening, patients may die of variceal bleeding or DIC. Clotting proteins can be detected by functional activity assays, ie, individual biological assays, or immunoassays for specific antigens. Normally, functional assays are closely related to immunoassays The synthesis of blood clotting protein is generally believed that, in addition to von Willebrand factor (hereinafter referred to