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目的 探讨肝硬化患者纤溶活性增高的机制。方法 根据Child Pugh分级把明确诊断为肝硬化的43例患者(男35例,女8例;年龄25~71岁,平均年龄51岁)分为3组,A组(A级)13例,B组(B级)15例,C组(C级)15例。另外B级和C级的患者根据腹水的有无,分别分成2组。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- D)。结果 在有腹水的16例(B级和C级)肝硬化患者中,所有患者血浆D D水平均大于1 0mg/L, FDP水平均大于5mg/L,平均D D含量为3 97mg/L。14例(B级和C级)没有腹水的肝硬化患者中只有5例血浆D- D水平大于0. 5mg/L、FDP水平大于5mg/L,平均D D含量为0 .77mg/L。另外,在同级病例中,有腹水患者的D- D水平远远大于没有腹水患者的D D水平,差异有统计学意义(P<0. 05)。有腹水患者的t PA水平略高于没有腹水的患者,但差异无统计学意义(P>0. 05),有腹水患者的PAI水平与无腹水患者的水平近似,差异无统计学意义(P>0 .05)。23例具有正常纤溶活性(FDP<5μg/ml;D -D<0. 5μg/ml)的病例,其中A级13例,B级6例,C级4例,t PA抗原随病情严重程度而显著性升高,差异有统计学意义(P<0. 05),而PAI活性在3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?
Objective To investigate the mechanism of increased fibrinolytic activity in patients with cirrhosis. Methods According to Child Pugh classification, 43 patients (35 males and 8 females, aged 25-71 years, mean age 51 years) with definite diagnosis of cirrhosis were divided into 3 groups: group A (grade A), group B Group (B grade) in 15 cases, C group (C grade) in 15 cases. In addition, patients of grade B and C were divided into two groups according to the presence or absence of ascites. Tissue plasminogen activator (t PA) antigen, tissue plasminogen activator inhibitor (PAI), fibrinogen (FDP) and D-dimer (D-D ). Results In 16 patients with ascites (grade B and C), the plasma D D levels were all above 10 mg / L, the FDP levels were above 5 mg / L, and the average D D levels were 3 97 mg / L in cirrhotic patients with ascites. Only 5 of 14 (Grade B and C) cirrhotic patients without ascites had plasma D-D levels greater than 0.5 mg / L, an FDP level greater than 5 mg / L, and an average D D level of 0.77 mg / L. In addition, in patients at the same level, the level of D-D in patients with ascites was significantly higher than that in patients without ascites (P <0.05). Patients with ascites had t PA levels slightly higher than those without ascites, but the difference was not statistically significant (P> 0.05). Patients with ascites had similar levels of PAI as those without ascites (P > 0 .05). Twenty-three patients with normal fibrinolytic activity (FDP <5μg / ml; D-D <0.5μg / ml) included 13 cases of A grade, 6 cases of B grade and 4 cases of C grade. (P <0.05), but the PAI activity in the three groups was similar (P> 0.05). In addition, by comparing the high fibrinolytic activity and normal fibrinolytic activity (B level?