Fibrinolysis in Cholestatic Jaundice
Fibrinolysis in Cholestatic Jaundice
复制标题
胆汁淤积性黄疸的纤维蛋白溶解
作者：
A. Jedrychowski;P. Hillenbrand;A. Ajdukiewicz;S. Parbhoo;S. Sherlock
对原发性胆汁性肝硬化（16例）和大胆管梗阻（10例，其中9例为癌）患者的纤溶系统进行了研究。两组患者的血浆纤维蛋白溶解（纤溶酶原激活物活性）均降低，纤维蛋白原升高，尤其是在大胆管梗阻患者中。这些变化与胆汁淤积程度有关。在原发性胆汁性肝硬化患者中，纤溶酶原激活物活性与血清甘油三酯水平呈负相关。两组的尿激酶抑制剂均减少，大导管阻塞患者的抗纤溶酶增加;纤维蛋白/纤维蛋白原降解产物在原发性胆汁性肝硬化中正常，在大导管阻塞中中度增加。这些纤溶指标均与胆汁淤积程度无关。在三位接受姑息性手术的大胆管阻塞患者中，纤溶活性和纤维蛋白原几乎恢复到正常水平。胆汁淤积性黄疸患者血浆纤溶功能下降和纤维蛋白原升高可能与脂质代谢改变有关。在因大胆管梗阻而接受手术的患者中，血栓形成的风险可能会增加。
The fibrinolytic system was studied in primary biliary cirrhosis (16 patients) and large bile duct obstruction (10 patients, nine of whom had carcinoma). Plasma fibrinolysis (plasminogen activator activity) was decreased and fibrinogen increased in both groups of patients, particularly in those with large duct obstruction. These changes were related to the degree of cholestasis. Plasminogen activator activity was inversely related to serum triglyceride levels in patients with primary biliary cirrhosis. Urokinase inhibitors were decreased in both groups and antiplasmins increased in patients with large duct obstruction; fibrin/fibrinogen degradation products were normal in primary biliary cirrhosis and moderately increased in large duct obstruction. None of these fibrinolytic indices was related to the degree of cholestasis. Fibrinolytic activity and fibrinogen returned almost to normal levels after palliative surgery in the three patients with large duct obstruction who were studied. The decreased plasma fibrinolysis and increased fibrinogen may be due to altered lipid metabolism in cholestatic jaundice. In patients undergoing surgery for large duct obstruction there may be an increased risk of thrombosis.