抄録
Activity and antigenicity of the factors of blood coagulation and fibrinolysis were examined in various kinds of liver diseases, including acute or chronic hepatitis, liver cirrhosis (LC), hepatoma and obstructive jaundice.
The most frequent abnormality of blood coagulation in these cases were the combination of decrease of platelet count, disturbance of its aggregation and increase of fibrin degradation product (FDP) in plasma.
The secondary abnormality was the prolongation of PT and PTT in addition to above findings.
The activity of Factor XIII (FXIII), its antigenicity of subunit A and subunit S were in normal level in chronic hepatitis group.
But these titers were high in LC and low in hepatoma.
The activity and antigenicity of plasminogen decreased in chronic hepatitis and obstructive jaundice, and especially in the cases of LC and hepatoma. The activity of plasmin inhibitors decreased in LC and hepatoma but antigenicity of α2-Macroglobulin (α2-M) was in normal limit.
The clinical courses of two cases of LC were presented which developed disseminated intravascular coagulopathy (DIC) during the intensive clinical observation.
The first case, 71 years old male, was LC and complicated with gastrointestinal tract bleeding. In this case, prolonged PT and PTT, decreased fibrinogen increased FDP were observed.
The second case, 66 years old male, had been suffering from LC and developed DIC after the injection of Factor IX concentrate.
In these cases, dissociation between activity and antigenicity of FXIII, plasmin, plasminogen, plasmin inhibitors and antithrombin III (AT-III) were observed.
Such dissociation between activity and antigenicity of those factors were reproducible in vitro experimentally by means of adding small by means of adding small amount of thrombin or streptokinase to normal plasma.
It was expected that the analysis of the relationship between activity and antigenicity of coagulation and fibrinolysis factors provides a new concept in elucidating the mechanism of multifarious bleeding tendency in the liver diseases.
