Changes in hemostatic parameters in hepatic veno-occlusive disease following bone marrow transplantation
Changes in hemostatic parameters in hepatic veno-occlusive disease following bone marrow transplantation
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DOI：
10.1038/sj.bmt.1700760
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发表时间：
1997-05-01
影响因子：
4.8
通讯作者：
KawaHa, K
中科院分区：
文献类型：
--
作者：
Park, YD;Yasui, M;KawaHa, K
肝静脉闭塞病（VOD）是骨髓移植（BMT）后的主要并发症。其预测、诊断和治疗尚不清楚。检查BMT后有或无VOD患者的止血参数的变化。27名儿童在BMT后进行了研究。其中8家开发了VOD。组织纤溶酶原激活物（t-PA）、纤溶酶原激活物抑制物1（派-1）、血栓调节蛋白（TM）、血管性血友病因子（vWF）、因子VII、纤维蛋白原（FBG）、FDP、D-二聚体（D-D）、纤溶酶原（PLG）、凝血酶-抗凝血酶III（达特）、α 2-纤溶酶抑制物/纤溶酶复合物（PIC）、抗凝血酶III（AT-III）、蛋白C、III型前胶原的N-末端前肽（P-III-P），从BMT前至BMT后第28天每周测量一次。VOD患者术后t-PA、派-1明显升高（P < 0.05），FBG明显下降（P < 0.05）。VOD前AT-Ⅲ和PLG也明显降低（P < 0.05）。其他止血参数无变化。因此，t-PA、派-1和FBG将出现用于诊断VOD的有用标志物，而AT-III和PLG是VOD的预测标志物。内皮细胞损伤后的凝血纤溶系统可能参与VOD的发生。
Hepatic veno-occlusive disease (VOD) is a major complication after bone marrow transplantation (BMT). Its prediction, diagnosis and treatment remain unclear. Examination was made of changes in hemostatic parameters in patients with or without VOD after BMT. Twenty-seven children were studied following BMT. Eight of them developed VOD. Tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), thrombomodulin (TM), von Willebrand factor (vWF), factor VII, fibrinogen (FBG), FDP, D-dimer (D-D), plasminogen (PLG), thrombin-antithrombin III (TAT), alpha 2-plasmin inhibitor/plasmin complex (PIC), antithrombin III (AT-III), protein C, N-terminal propeptide for type III procollagen (P-III-P), were measured weekly from pre-BMT to day 28 after BMT. In VOD patients, t-PA and PAI-1 significantly increased (P < 0.05) and FBG significantly fell during the post-transplant period (P < 0.05). Significantly low AT-III and PLG were also noted before VOD (P < 0.05). There were no changes in other hemostatic parameters. t-PA, PAI-1 and FBG would thus appear useful markers for the diagnosis of VOD, and AT-III and PLG, predictive markers for VOD. The coagulation-fibrinolysis system following endothelial cell damage mag contribute to the onset of VOD.