A study on the correalation between hemostatic function and liver diseases

Abstract

Nowadays There is no donbt that coagulation studies of hepatic damages give information for the severity, but the clear relationship in this diagnostic value is not established yet.Present studies indicated that hemostatic tests have some pathophysiogical significance for disturbed liver functions.Coagulation and fibrinolytic tests, such as bleeding time (BT), clotting time (CT), recalcification time (RT), prothrombin time (PT), thrombotest (TT) hepaplastintest (HPT), activated partial thromboplastin time (APTT), T E G, concentration of factor V, VIII, IX and fibrinogen (Fbg.), platelet counts (Plt. C), F D P, plasminogen (Plg.), antithrombin III (A T III), α2-macroglobulin (α2-Mac.), and α1-antitrypsin (α1-A T) were made on 6 cases with acute hepatitis (A H), 14 with inactive chronic hepatitis (inact. C H), 4 with active chronic hepatitis (act. C H), 12 with liver cirrhosis without ascites (L C ascites(-)), 3 with liver cirrhosiswith ascites (L C ascites(+)), and 7 other liver disorders such as Banti's syndrome, acute cholestasis and hypercitrullinemia.BT, RT and CT were almost in normal range. Prolonged PT and decreased TT and HPT value were shown in CH and L C groups, but in A H, PT TT and HPT were all in normal range. APTT was prolonged in many cases of each group. In L C with or without ascites, T E G ma was shortened and Plt. C decreased. Low concentration of F V and IX was revealed in many cases with C H and L C. Fbg. level elevated in some cases with A H and other liver disoders, but in most cases with C H and L C showed its decrease. In each group. F D P was almost in normal and Plg. was not elevated.Fibrinolytic inhibitors showed variable changes in same group. In A H, three inhibitors were all in normal range. In C H, A T III was in normal range and α2-Mac. and α1-A T were slightly increased. In L C ascites(-), A T III decreased and α2-Mac. and α1-A T increased. In L C ascites(+), A T III decreased, α2-Mac. increased and α1-A T was in normal.There were 19 cases out of 46, with normal values in screening liver function tests in the present study. They had abnormal values with high frequency in TT, APTT, TEGma, α2-Mac., Plt. C, PT and so on. Thirty-three percent of them showed decreased HPT value. So that these coagulation and fibrinolytic tests may be utilized in the diagnostic procedure for liver functions.Abnormal hemostatic results were reffered with TTT, ZTT, Ch-E and serum albumin level in the presnt studies which were performed mainly on chronic liver diseases, and thues these Suggested disturbed protein metabolism, especially in live cells.