Document Detail

Clinical significance of haemostatic tests in chronic liver disease.
MedLine Citation:
PMID:  22919876     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine different haemostatic tests in patients with various degrees of liver parenchymal damage and to rule out their role in assessing parenchymal hepatocyte dysfunction.
METHODS: Seventy-five patients with chronic liver disease were included and due to their degree of liver damage categorized into three groups: group one patients with chronic viral hepatitis and early stage of fibrosis (n=30), group two patients with compensated cirrhosis (n=17) and group three patients with decompensated liver cirrhosis (n=28). The following haemostatic tests were measured: activated partial thromboplastin time, prothrombin time, plasma fibrinogen, antithrombin III and protein C and plasma D-dimer.
RESULTS: Antithrombin III levels showed significant reduction in compensated (83.86 +/- 19.49%) and decompensated cirrhosis (52.64 +/- 14.31%; p < 0.001), while protein C activity exhibited significant decrease in all the patients group, including patients with chronic viral hepatitis (90.58 +/- 11.03, 74.65 +/- 19.56, 41.11 +/- 18.35%; p < 0.001) in comparison with controls. Correlation between antithrombin III (Pearson ro = -.931, p < 0.01) and protein C (Pearson ro = -.789, p < 0.01) and clinical degree of chronic liver disease were found. D-dimer levels were significantly increased in decompensated cirrhosis (832.26 +/- 537.19 microg/L; p < 0.001) and no significant difference was found in group two and three when compared with healthy controls.
CONCLUSIONS: In advanced chronic liver disease anticoagulant activitiy may reflect hepatocellular dysfunction. Protein C activity may be used as a senstive marker of hepatocellular damage even in those patients with mild liver affection whereas D-dimer levels may be considered as an important sign of decompensation in cirrhotic patients. Further studies are necessary to approve whether these parameters could be used as clinical routine markers of hepatocyte function in chronic liver disease.
Aida Saray; Rusmir Mesihovic; Nenad Vanis; Srdjan Gornjakovic; Dzanela Prohic
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medical archives (Sarajevo, Bosnia and Herzegovina)     Volume:  66     ISSN:  0350-199X     ISO Abbreviation:  Med Arch     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-27     Completed Date:  2012-10-05     Revised Date:  2014-07-07    
Medline Journal Info:
Nlm Unique ID:  101635337     Medline TA:  Med Arch     Country:  Bosnia and Hercegovina    
Other Details:
Languages:  eng     Pagination:  231-5     Citation Subset:  IM    
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MeSH Terms
Antithrombin III / analysis
Biological Markers / blood
Blood Coagulation Tests*
Chronic Disease
Fibrin Fibrinogen Degradation Products / analysis
Fibrinogen / analysis
Hepatitis B, Chronic / blood*
Hepatitis C, Chronic / blood*
International Normalized Ratio
Liver Cirrhosis / blood*,  diagnosis
Middle Aged
Partial Thromboplastin Time
Protein C / analysis
Reg. No./Substance:
0/Biological Markers; 0/Fibrin Fibrinogen Degradation Products; 0/Protein C; 0/fibrin fragment D; 9000-94-6/Antithrombin III; 9001-32-5/Fibrinogen

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