Haemostatic Imbalance in Patients With Chronic Liver Disease- Its Relation to Severity and Outcome
试验速览
- 阶段
- 不适用
- 入组人数
- 100
- 主要终点
- Assesment of haemostatic profile in different stages of liver cirrhosis
研究概览
简要总结
To assess the level of protein C, S ,antithrombin in patients with liver cirrhosis To correlate the level of these parameters with the degree of liver cirrhosis To correlate the level of procoagulants with the level of anticoagulant proteins in liver cirrhosis
详细描述
The liver has a cardinal role in the haemostatic system. Liver has the major role in synthesizing all clotting factors and coagulation inhibitors. Under the physiological conditions the balanced levels of procoagulant and anticoagulants determine the risk of hemorrhage and thrombosis.
In chronic liver disease due to chronic hepatitis and underlying cirrhosis, this haemostatic imbalance leads to hypercoagulability which favors thrombosis despite the longer coagulation times of their plasma, compared with that of healthy individuals. The end stage cirrhosis is however predominately associated with bleeding tendency.
Protein C (PC) and protein S (PS) are vitamin K-dependent glycoproteins, that act as natural anticoagulants.
Antithrombin III (AT III) is a natural anticoagulant that is synthesized exclusively in parenchymal cells of the liver The cause of hypercoagulability in chronic liver disease is the reduced level of protein C and increased level of factor VIIIa .As a consequence of hypercoagulability, the deep vein thrombosis, pulmonary embolism, hepatic and portal vein thrombosis may occur.
Varnika et al 2017 found a significantly low protein C value in both chronic hepatitis and cirrhosis group when compared with control group.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Prospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients diagnosed as liver cirrhosis confirmed clinical , biochemical and ultrasonography.
- •severity of cirrhosis was assessed according to Child-Pugh score and MELD score.
排除标准
- •history of bleeding or thrombotic disorder,
- •history of renal disease, diabetes mellitus,
- •ongoing or recent pregnancy,
- •recent history of transfusion of blood products,
- •current anticoagulation therapy.
- •Hepatocellular carcinoma
结局指标
主要结局
Assesment of haemostatic profile in different stages of liver cirrhosis
时间窗: baseline
assessment of the level of protein C, S ,antithrombin in patients with liver cirrhosis, and correlate the level of these parameters with the degree of liver cirrhosis
次要结局
- The value of anticoagulant use in patients with liver cirrhosis(baseline)
研究者
Sara Mohammed Mahrous Sayed
principal investigator
Assiut University