STUDY OF THE COAGULATION INHIBITORS IN PATIENTS WITH LIVER CIRRHOSIS

Abstract

The hepatocyte is the principal site of synthesis of all coagulation proteins-with the exception of von Willebrand factor and factor VIIIC. Inhibitors, which modulate the coagulation cascade are also synthesized by the liver. These include antithrombin III, protein C and S, and heparin co­ factor II. Precursors of factors II, VII, IX, X and the antithrombotic factors, protein S and protein C are synthesized by the liver and are also called vitamin K dependent factors.

Disturbed blood coagulation in patients with hepatocellular disease is particularly complex. This is due to the many often-conflicting changes in the pathways, which lead to fibrin production at the same time as changes in the fibrinolytic process. So Patients with liver cirrhosis are at higher risk of bleeding, also in these patients arterial and venous thrombosis were recorded e.g. myocardial infarction, stroke and more frequently portal vein thrombosis.

On the other hand in patients with thromboembolic episodes, there were remarkable increase in the incidence of resistance to activated protein c.

The aim of this work was to study the coagulation inhibitors (protein C, protein S) and activated protein C resistance in patients with liver cirrhosis.