抄録
Coagulation screening tests including prothrombin time, hepaplastin test, kaolin-activated partial thromboplastin time, serial thrombin time 30', fibrinogen, fibrinogen and fibrin degradation products (FDP), and platelet count seem to be influenced by the capacity of the liver to produce proteins such as serum albumin, cholinesterase, and almost of all coagulo-fibrinolytic factors.
So we studied the correlation between coagulation screening tests and histological pictures of biopsy specimens of liver in chronic liver diseases. Then we designed coagulation disturbance score (CDS) to express the severity of hepatic parenchyma damage by the degree of deteriolation of coagulation screening tests. On the other hand, histological findings were classified as liver cell damage score (LCDS) and liver fibrosis score (LFS) according to degrees of liver cell necrosis and liver fibrosis. And histological diagnoses of chronic liver diseases used were liver cirrhosis, active stage (LC (a)), liver cirrhosis, inactive stage (LC (i)), chronic active hepatitis with lobular disorganization (CH (a)) c LD), chronic active hepatitis (CH (a)), and chronic inactive hepatitis (CH (i)).
In LC (a), compared with other types of chronic liver diseases, CDS was significantly high and also platelet count below 10×104/cμ, cholinesterase below normal value in our laboratory (4.4IU/ml). In LC (i) and CH (i), the lower the CDS, the higher the LCDS. It was postulated that hyperproduction of coagulation factors might be induced by the regeneration of liver cell after inflammation or by the inflammatory stimulation on hepatic parenchyma. In CH (a) c LD, which is a histological stage from chronic hepatitis to liver cirrhosis, CDS was significantly correlated with LCDS. On the other hand, CDS wasn't dependent on LFS in all types of chronic liver diseases.
CDS had significant correlation with serum albumin, cholinesterase and ICG 15'.
Conclusively, in chronic liver diseases, especially in liver cirrhosis, increase of CDS means that functional capacity of the liver gets worse.
