CAJ | 학술논문

目的：研究由肝脏合成的促抗凝因子、纤维蛋白原降解产物等成分在不同肝病中的变化特点，探讨肝脏疾病凝血与出血之间的平衡关系。方法（1）凝血因子活性检测（F：C）：包括 FⅡ：C、FⅤ：C、FⅦ：C、FⅧ：C、FⅨ：C、FⅩ：C、FⅪ：C、FⅫ：C 均采用一期凝固法，试剂来自德国 Simens 公司，所用仪器为美国 ACL advance；（2）活化部分凝血酶时间（APTT）、凝血酶时间（TT）、凝血酶原时间（PT）、纤维蛋白原（Fig）测定采用凝固法，仪器为美国Backman 公司 ALT TOP，试剂与仪器配套；（3）蛋白 C（PC）、抗凝血酶Ⅲ（AT-Ⅲ）活性测定采用发色底物法，仪器均为法国 stago 公司的 sta-R，试剂与仪器配套；（4）纤维蛋白原降解产物（FDP）含量检测采用免疫比浊法，试剂为日本一化，仪器为法国 stago 公司的 sta-R；D-二聚体（D-D）含量检测采用免疫比浊法，试剂为法国 Diagnostic stago 公司提供的 STA-Liatest D-Di 试剂盒，仪器为法国 stago 公司的 sta-R 全自动血凝仪；（5）血小板（PLT）计数采用电阻抗法，仪器为日本 sysmex 的 XE-2100；结果除 FⅧ外由肝实质细胞合成的凝血因子、抗凝蛋白均降低；凝血象延长；FDP，D-D 含量升高。结果除 FⅧ外由肝实质细胞合成的凝血因子、抗凝蛋白均降低；凝血象延长；FDP，D-D 含量升高。结论肝脏疾病随着病情的发展，由肝实质细胞合成的促抗凝成分伴发平行减少；纤溶活性增强致凝血与抗凝平衡失衡，此平衡紊乱可能与终末期肝病患者出血有关。
목적：연구유간장합성적촉항응인자、섬유단백원강해산물등성분재불동간병중적변화특점，탐토간장질병응혈여출혈지간적평형관계。방법（1）응혈인자활성검측（F：C）：포괄 FⅡ：C、FⅤ：C、FⅦ：C、FⅧ：C、FⅨ：C、FⅩ：C、FⅪ：C、FⅫ：C 균채용일기응고법，시제래자덕국 Simens 공사，소용의기위미국 ACL advance；（2）활화부분응혈매시간（APTT）、응혈매시간（TT）、응혈매원시간（PT）、섬유단백원（Fig）측정채용응고법，의기위미국Backman 공사 ALT TOP，시제여의기배투；（3）단백 C（PC）、항응혈매Ⅲ（AT-Ⅲ）활성측정채용발색저물법，의기균위법국 stago 공사적 sta-R，시제여의기배투；（4）섬유단백원강해산물（FDP）함량검측채용면역비탁법，시제위일본일화，의기위법국 stago 공사적 sta-R；D-이취체（D-D）함량검측채용면역비탁법，시제위법국 Diagnostic stago 공사제공적 STA-Liatest D-Di 시제합，의기위법국 stago 공사적 sta-R 전자동혈응의；（5）혈소판（PLT）계수채용전조항법，의기위일본 sysmex 적 XE-2100；결과제 FⅧ외유간실질세포합성적응혈인자、항응단백균강저；응혈상연장；FDP，D-D 함량승고。결과제 FⅧ외유간실질세포합성적응혈인자、항응단백균강저；응혈상연장；FDP，D-D 함량승고。결론간장질병수착병정적발전，유간실질세포합성적촉항응성분반발평행감소；섬용활성증강치응혈여항응평형실형，차평형문란가능여종말기간병환자출혈유관。
Objective To study the changing characteristics of coagulation factors and fibrinogen degradation products in different liver disease,liver disease,blood clotting and bleeding balance between relations,to explore the balance between coagulation and bleeding of hepatic diseases.Methods Coagulation factor Ⅱ,Ⅴ,Ⅶ,Ⅷ,Ⅸ,Ⅹ,Ⅺ,Ⅻ activity was detected by one-stages clotting method.Coagulogram such as APTT,TT,PT and Fig were measured by solidification method.Antithrombin Ⅲ (AT-Ⅲ),protein C (PC)activity were measured by chromogen-ic substrate assay.FDP concentration was detected using immunoturbidimetry.Results Except for FⅧ,coagulation factors and anticoagulant proteins synthesized by the liver decreased,coagulogram extended,FDP and D-D concen-tration increased in blood.Conclusion With the progression of liver diseases,the procoagulation and anti-coagulation elements synthesized by liver were parallelly reduced.Fibrinolysis activity was enhanced,which led to the imbalance between blood clotting and anti-clotting .This might be an important cause for bleeding in the end-stage of liver dis-ease patients.