肝硬化患者纤溶活性增高与组织纤溶酶原激活物及其抑制剂的关系  

Relationship of Hyperfibrionlysis with Tissue Plasminagen Activator and Its Inhibitor in Patients with Liver Cirrhosis

作　　者：李力[1] 肖扬[1] 蒋祖军[1] 

机构地区：[1]广州军区广州总医院血液科,广州510010

出　　处：《华南国防医学杂志》2007年第4期22-24,共3页Military Medical Journal of South China

摘　　要：目的探讨肝硬化患者纤溶性增高与组织纤溶酶原激活物(t-PA),组织纤溶酶原激活物抑制剂(PAI)的关系。方法根据Child-Pugh分级把明确诊断为肝硬化的35例患者分为三组,A级10例,B级13例,C级12例。对每例样本检测组织纤溶酶原激活物(t-PA)抗原,组织纤溶酶原激活物抑制剂(PAI),纤维蛋白(原)降解产物(FDP)和D-二聚体(D-dimer)。结果22例具有正常纤溶活性(FDP<5μg/ml;D-dimer<0.5μg/ml)的病例中,其中A级12例,B级6例,C级4例,tPA抗原随病情严重程度而显著性升高,差异有显著性意义(P<0.05),而PAI活性在三组结果近似(P>0.05)。另外,通过比较高纤溶活性和正常纤溶活性(B级和C级)t-PA/PAI变化。我们注意到t-PA在纤溶活性高的患者略高于正常纤溶患者,但差异没有显著意义(P>0.05)。PAI在两组间结果近似,差异没有显著性意义(P>0.05)。结论t-PA随病情加重而显著性升高,PAI随病情加重变化不大;t-PA/PAI失衡不是肝硬化患者纤溶升高的主要因素。Objective To Investigate the relationship of Hyperfibrionlysis with tissue plasminogen avtivator （t-PA） and plasminogen activator inhibitor （PAD in patients with liver cirrhosis associated with viral hepatitis. Methods Thirty-five patients （31 men and 4 women; age 27-73years） with liver cirrhosis were divided into three groups, i.e. grade A（10 cases）, B（13 cases） and C（ 12 cases） according Chil＆Pugh classification. The plasma contents of t-PA antigen, PAI activity, fibrin or fibrinogen decomposition products （FDP）, and D-dimer were determind in all the patients. Results Of 22 pa- tients without systemic signs of hyperfibrinolysis, 12 belonged in grade A, 6 in grade B and 4 in grade C. There were significantly difference in plasma t-PA content among grades A （6. 02 ± 4. 15）ng/ml, B（ 13. 1 ± 6. 8）ng/ml and C（22.5 ± 9. 3） ng/ml （P〈0.05）, and there was insignificant difference in PAI activity among grade A, B and C in the patient without systemic signs of hyperfibrinolysis （P〉0. 05）. There were insignificant difference in t-PA antigen and PAI plasma contents between the patients with hyperfibrinolysis and the patients with normal fibrinolysis （P〉0. 05）. Conclusion The plasma content of t-PA antigen significantly increases and the plasma content of PAI activity is insignificantly changed along with the deterioration of the condition in the patients with liver cirrhosis. The imbalance of t-PA and PAI was not a main cause of hyperfibrinolysis in the patients with liver cirrhosis.

关 键 词：高纤溶活性 组织纤溶酶原激活物 组织纤溶酶原激活物抑制剂 肝硬化 

分 类 号：R575.2[医药卫生—消化系统]