STUDY OF FIBRINOLYSIS IN CASES OF LIVER CIRRHOSIS

Abstract

The regulation of blood coagulation is dependent on complex interplay between Procoagulant, anticoagulant and fibrinolytic proteins, most of these proteins are Synthesized in the liver and their levels are altered in patients with chronic liver Disease. The liver also plays an important role in regulation of haemostasis through the clearance of activated clotting factors. This critically balanced coagulation system is dysregulated in chronic liver diseases. In moderate liver disease, bleeding Disorders predominate while in the far advanced liver disease intravascular coagulation is commonly observed (Castelino and Salem, 1997). It was reported that accelerated fibrinolysis might have significant clinical consequences m indiviguals with liver cirrhosis (Francis and Feinstein, 1984). Aiming to study the fibrinolytic affection in cases of liver cirrhosis with severe hepatic affection this study was conducted on twenty-five patients with grade-B and grade-C liver cirrhosis with various bleeding problems (groupll, HI) and ten patients with grade-A liver cirrhosis with no bleeding problems as a control group (group I) (according to Child­ Pugh classification) The study included careful history taking, physical examination, routine lab and coagulation profile namely Prothrombin time, concentration, activated partial thromboplastin time, international normalization ratio (PT, PC, aPTT and TNR), Thrombin time, Serum fibrinogen and assay of D- Dimer in the plasma and lastly Abdominal ultrasound examination for all patients.