الفهرس | Only 14 pages are availabe for public view |
Abstract The liver plays a central role in the clotting process, and acute and chronic liver diseases are invariably associated with coagulation disorders due to multiple causes: decreased synthesis of clotting and inhibitor factors, decreased clearance of activated factors, quantitative and qualitative platelet defects, hyperfibrinolysis, and accelerated intravascular coagulation. Peculiar coagulation disorders are prevalent in patients with chronic liver diseases. Methods. We have evaluated a number of haemostatic variables synthesised by the liver (international normalised ratio (INR), activated partial thromboplastin time (APTT), Fibrinogen level, D-dimer level, as well as Protein C concentration) in: (a) patients with liver cirrhosis (n = 30), (b) patients with chronic hepatitis (n = 52) and (c) controls (n = 52). Results. International normalised ratio (INR), activated partial thromboplastin time (APTT), as well as D-dimer level were significantly increased in patients with liver cirrhosis in comparison to the control. Fibrinogen level was significantly decreased in patients with liver cirrhosis in comparison to the control. Protein C concentration was significantly decreased in patients with chronic hepatitis as well as liver cirrhosis in comparison to the control. Conclusion. The effect of liver diseases on haemostasis is complex and multifactorial. The prolonged APTT, INR and the increased D-dimer level, together with decreased fibrinogen level and protein C concentration seem to be related to the extent of the chronic liver disease, so these parameters can be used as good indicator for severity of liver diseases |