Does endothelium agree with the concept of idiopathic hepatic vessel thrombosis?

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:csnzz
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AIM:To investigate the major steps of thrombogenesisand to identify the differences in these steps betweenidiopathic patient group and control group.METHODS:Fibrinogenesis was studied by measuringthe activated factor Ⅶ,total and free levels of tissuefactor pathway inhibitor(TFPI).The fibrinolysis step wasinvestigated by determining the global fibrinolytic capa-city.The endothelial function was assessed by measuringthe levels of soluble adhesion molecules,namely solub-le intercellular adhesion molecule 1(sICAM-1),solublevascular cell adhesion molecule 1(sVCAM-1)and solubleE-selectin molecule.The exclusion criteria from“idiopat-hic”patient group were abdominal surgery,pregnancy,use of oral contraceptives,anti-phospholipid syndrome,Behcet’s disease,cancer,myeloproliferative diseases.The congenital factors like mutations of factor-V Lei-den and prothrombin,deficiencies of proteins C and S,antithrombin,hyperhomocysteinemia and hyperfibrino-genemia were ruled out.The total number of patientswas reduced from 96 to 9(7 with portal vein thrombosis,2 Budd Chiari syndrome)by exclusion criteria.RESULTS:The levels of adhesion molecules sICAM-1,sVCAM-1,free TFPI levels and global fibrinolytic capacitywere significantly different(P<0.05)in the patient groupindicating an endothelial dysfunction and a lower fibri-nolytic activity.CONCLUSION:These results show that this patientgroup should be tested by means of endothelial dysfunc- tion and managed differently. To investigate the major steps of thrombogenesis and to identify the differences in these steps between idiopathic patient group and control group. METHODS: Fibrinogenesis was studied by measuring the activated factor VII, total and free levels of tissue factor pathway inhibitor (TFPI). The fibrinolysis step was investigated by determining the global fibrinolytic capa-city. The endothelial function was assessed by measuring the levels of soluble adhesion molecules, solubility-le intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1) molecule. The exclusion criteria from “idiopat-hic ” patient group were abdominal surgery, pregnancy, use of oral contraceptives, anti-phospholipid syndrome, Behcet’s disease, cancer, myeloproliferative diseases. The congenital factors like mutations of factor- den and prothrombin, deficiencies of proteins C and S, antithrombin, hyperhomocysteinemia and hyperfibrino-genemia were ruled out. The total number of pati entswas reduced from 96 to 9 (7 with portal vein thrombosis, 2 Budd Chiari syndrome) by exclusion criteria .RESULTS: The levels of adhesion molecules sICAM-1, sVCAM-1, free TFPI levels and global fibrinolytic capacity significantly different (P <0.05 ) in the patient groupindicating an endothelial dysfunction and a lower fibri-nolytic activity. CONCLUSION: These results show that this patientgroup should be tested by means of endothelial dysfunc tion and managed differently.
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