The objective of this study was to investigate whether ascites favours the occurrence of systemic hyperfibrinolysis in liver cirrhosis (LC) patients. We studied coagulation and fibrinolytic systems in 10 LC patients with ascites and 10 without ascites, matched for age, sex and degree of liver failure. In patients with ascites blood coagulation and fibrinolytic studies were performed also after ascites remission. LC patients had significantly higher plasma values of human prothrombin fragment F 1+2, a marker of thrombin generation (p=0.0001), lower plasma fibrinogen (p<0.02) and prothrombin activity (p=0.001) than normal controls. Higher plasma levels of tissue plasminogen activator (t-PA) antigen (p<0.01), F 1+2 (p=0.03) and D-dimer (p=0.02) were detected in ascitic patients compared to non ascitic ones. All patients with ascites had F 1+2>1nM (mean+2 SD of controls) and high values of plasma D-dimer. After ascites remission, a significant increase of plasma fibrinogen (p<0.02) and a significant decrease of plasma D-dimer (p<0.01), F 1+2 (p<0.02) and t-PA antigen (p<0.02) were found; liver failure scored by Child-Pugh's criteria and prothrombin activity did not change significantly. This study shows that ascitic patients have a hyperfibrinolytic condition secondary to intravascular clotting activation. The reduction of hyperfibrinolysis by ascites remission suggests that ascites favours the occurrence of this coagulopathy but the mechanism needs to be further investigated.
INTRAVASCULAR CLOTTING ACTIVATION AND SYSTEMIC HYPERFIBRINOLYSIS IN PATIENTS WITH SEVERE LIVER-CIRRHOSIS - THE ROLE OF ASCITES / C., Quintarelli; Ferro, Domenico; Basili, Stefania; Alessandri, Cesare; M., Alessandroni; Violi, Francesco. - In: FIBRINOLYSIS. - ISSN 0268-9499. - STAMPA. - 8:6(1994), pp. 353-358. [10.1016/0268-9499(94)90003-5]
INTRAVASCULAR CLOTTING ACTIVATION AND SYSTEMIC HYPERFIBRINOLYSIS IN PATIENTS WITH SEVERE LIVER-CIRRHOSIS - THE ROLE OF ASCITES
FERRO, Domenico;BASILI, Stefania;ALESSANDRI, Cesare;VIOLI, Francesco
1994
Abstract
The objective of this study was to investigate whether ascites favours the occurrence of systemic hyperfibrinolysis in liver cirrhosis (LC) patients. We studied coagulation and fibrinolytic systems in 10 LC patients with ascites and 10 without ascites, matched for age, sex and degree of liver failure. In patients with ascites blood coagulation and fibrinolytic studies were performed also after ascites remission. LC patients had significantly higher plasma values of human prothrombin fragment F 1+2, a marker of thrombin generation (p=0.0001), lower plasma fibrinogen (p<0.02) and prothrombin activity (p=0.001) than normal controls. Higher plasma levels of tissue plasminogen activator (t-PA) antigen (p<0.01), F 1+2 (p=0.03) and D-dimer (p=0.02) were detected in ascitic patients compared to non ascitic ones. All patients with ascites had F 1+2>1nM (mean+2 SD of controls) and high values of plasma D-dimer. After ascites remission, a significant increase of plasma fibrinogen (p<0.02) and a significant decrease of plasma D-dimer (p<0.01), F 1+2 (p<0.02) and t-PA antigen (p<0.02) were found; liver failure scored by Child-Pugh's criteria and prothrombin activity did not change significantly. This study shows that ascitic patients have a hyperfibrinolytic condition secondary to intravascular clotting activation. The reduction of hyperfibrinolysis by ascites remission suggests that ascites favours the occurrence of this coagulopathy but the mechanism needs to be further investigated.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
