论文部分内容阅读
目的:研究肝硬化患者血浆凝血—抗凝系统的变化,并探讨其临床意义。方法:肝硬化患者50例(代偿期30例,失代偿期20例),检测其血浆中凝血因子与抗凝蛋白。凝血因子抗原(F:Ag)用火箭电泳法,凝血因子活性(F:C)用一期凝血法或发色底物法;抗凝血酶原(AT:Ag)用免疫浊度法,抗凝血酶活性(AT:A)用发色底物法;蛋白C抗原(PC:Ag)用放射免疫法,蛋白C活性(PC:A)用发色底物法;补体1抑制剂(Cl-Inh:Ag与Cl-Inh:A)用免疫扩散法;组织因子途径抑制物抗原(TFPI:Ag)用ELISA法,组织因子途径抑制物活性(TFPI:A)用发色底物法。结果:肝硬化患者凝血因子除FⅧ外均有不同程度的降低,其中FⅤ与纤维蛋白原的降低见于失代偿期。肝硬化患者抗凝蛋白除TFPI外均降低。结论:由于凝血因子与抗凝因子多在肝脏制造,肝硬化时肝组织受到损伤致凝血因子与抗激因子制造障碍。其测定结果可用以评价肝脏损伤,防治出血或血栓形成,判断预后。
Objective: To study the changes of plasma coagulation-anticoagulation system in patients with cirrhosis and to explore its clinical significance. Methods: Fifty patients with cirrhosis (30 patients with decompensation and 20 patients with decompensation) were enrolled in this study. Plasma coagulation factor and anticoagulant protein were detected. The coagulation factor antigens (F: Ag) were determined by rocket electrophoresis, clotting factor activity (F: C) by the one-stage coagulation or chromogenic substrate method, antithrombin (AT: Ag) by immunoturbidimetry, Thrombin activity (AT: A) was determined by chromogenic substrate assay; protein C antigen (PC: Ag) by radioimmunoassay; protein C activity -Inh: Ag and Cl-Inh: A) Immunofluorescence; TFPI: Ag was assayed by ELISA using the chromogenic substrate method for tissue factor pathway inhibitor activity (TFPI: A). Results: In patients with cirrhosis, coagulation factors except F Ⅷ all decreased to some extent, and the decrease of F Ⅴ and fibrinogen was found in decompensation. Anticoagulant protein in patients with cirrhosis except TFPI decreased. Conclusion: Due to the fact that clotting factor and anticoagulant factor are mostly produced in the liver, the liver tissue is damaged during liver cirrhosis and clotting factors and anti-inflammatory factors are impaired. The results can be used to evaluate liver damage, prevent bleeding or thrombosis, to determine the prognosis.