Abstract
The function of coagulation and fibrinolysis was examined in various hepatic diseases. Coagulation and fibrinolytic test such as prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombotest (TT), plasminogen (plg), FDP, antithrombin III (AT-III), α1-antitrypsin (α1AT), α2-macroglobulin (α2M), inter-α-trypsin inhibitor (IαI), α1-antichymotrypsin (α1X) and immunoglobulin were measured in 75 cases with various hepatic diseases.
In acute hepatitis, PT prolonged, but fibrinogen and α1AT slightly increased, α1X slightly decreased, and FDP and TEG showed almost normal range.
In chronic hepatitis, PT prolonged, fibrinogen, α1AT and α2M increased, plg and IαI slightly decreased, TEG k prolonged, TEG r and TEG ma showed almost normal range.
In liver cirrhosis, PT significantly prolonged, but aPTT, TT, fibrinogen and FDP showed almost normal range. On the other hand plg, AT-III and IαI significantly decreased, and α1AT and α2M increased. Alpha2M, AT-III and plg were remarkably decreased in a group which PT showed more than 14 seconds.
Relationship between PT and α2M or AT-III or plg were negative. Positive correlation between PT and FDP was observed. Correlation between AT-III and α2M or IαI were positive. And correlation between plg and α2M or IαI were positive. TEG k prolonged. TEG ma decreased.
In primary hepatoma, PT prolonged, α1AT, α1X increased, and AT-III, IαI and plg decreased. TEG k shortened. TEG ma increased.
It was demonstrated that the identification of coagulation and fibrinolysis is an indispensable tool in the diagnosis as well as in the evaluation of the course and prognosis of diseases of the liver.
