肝脏疾病疑血功能障碍与内毒素血症

HEMOSTATIC PROBLEMS AND ENDOTOXEMIA IN LIVER DISEASE

本研究发现肝病患者常发生内毒素血症,其发生率的高低与肝脏病变的损伤程度和范围相平行,与枯否细胞吞噬功能有关。肝病的凝血障碍属多因子性,不仅有凝血因子的改变,也有抗凝血酶Ⅲ的降低。多元线性相关分析揭示:内毒素血症发生率与Fn,凝血因子异常和AT-Ⅲ的变化显著相关(P<0.001),其中以HPT、FⅡ、AT-Ⅲ、Fn、ⅧR:Ag与内毒素血症的相关性更为密切,提示在引起肝脏疾病凝血功能障碍的诸因素中。

Plasma Limulus Lysate assay, fibronectin, blood coagulation picture (Fbg, FⅡ, HPT, PT, ⅧR:Ag) and antithrombin-Ⅲ were determined in G1 patients with liver disease. The frequency of endotoxemia depended upon the degree and extent of hepatic injury and the phagocytic activity of the Kupffer cells. The coagulation abnormalities were multifactorial, there were not only the changes of clotting proteins, but also the diminution of antithrombin-Ⅲ. Multivariate analysis showed that the frequency of endotoxemia was closely correlated with the changes of fibronectin, clotting proteins and antithrombin-III (P<0.001), among which the changes of HPT, FⅡ, AT-Ⅲ, Fn, VIIIR:Ag were statistically significant. Our data suggested that among these factors,which cause clotting abnormalities in liver disease,the endotoxemia should not be ignored