Platelet aggregation test (PAgT), platelet adhesion test (PAdT), thromboplastic activity of factor Ⅷ (FⅧ∶c), antithrombin Ⅲ activity (AT-Ⅲ∶a), antithrombin Ⅲ antigen (AT-Ⅲ∶Ag), von willebrand factor (vWF) and fibrinogen (Fg) were measured in 33 patients with biliary tract diseases and 24 normal individuals. The results showed that there was no significant difference in PAgT, PAdT, AT-Ⅲ∶a and AT-Ⅲ∶Ag between the two groups (Ｐ＞0.05). Fg increased more significantly in biliary tract disease than in the controls (Ｐ＜0.01). FⅧ∶c increased more significantly in patients with obstructive jaundice than in that of nonjaundiced and the controls (Ｐ＜0.01). The levels of vWF increased higher and higher in the sequence of patients with no jaundice, obstructive jaundice due to benign diseases and obstructive jaundice due to malignancy(Ｐ＜0.01). In conclusion, Fg, FⅧ∶c and vWF increased in patients with biliary tract disease.
Objective To investigate whether the sleep-induced hypoxemia ( SIH) at different time and different level have different effects on pulmonary emphysema and coagulation systemfunction in the rats with pulmonary emphysema. Methods Thirty Wistar rats were randomly divided into three groups( n = 10 in each group) . All rats were exposed to cigarette smoke twice a day ( 30 min each time) . From29th day on, the rats in Group A ( pulmonary emphysema with short SIH) were also exposed to mixed gas of 12. 5% oxygen for 1. 5 hours during sleeping time every day ( the expose time was divided into 4 periods, 22. 5 min each) . The rats in Group B ( pulmonary emphysema with mild SIH) were also exposed to mixed gas of 15% oxygen for three hours during sleeping time every day( the expose time was divided into 4 periods, 45 min each) . The rats in Group C( pulmonary emphysema with standard SIH) were also exposed to mixed gas of 12. 5% oxygen for three hours during sleeping time every day( the expose time was divided into 4 periods,45 min each) . After continuous exposure for 56 days, the rats were sacrificed. Semi-quantitative image analytic method was employed for histopathological analysis including pathological score of lungs, mean linear intercept ( MLI) and mean alveolus number( MAN) . ATⅢ, FIB, vWF, FⅧ were measured. Results All animals in three groups manifested the histopathological features of emphysema. Pathological scores of lungs and MLI of every group were significantly different from each other( F = 21. 907, F = 18. 415, all P lt; 0. 05) , Group A [ ( 61. 90 ±4. 25) % , ( 92. 45 ±1. 78) μm] and Group B[ ( 64. 60 ±3. 95) % , ( 92. 80 ±3. 65) μm] were significantly lower than Group C[ ( 73. 30 ±3. 86) % , ( 99. 32 ±2. 81) μm, q= 8. 96, q =6. 84, q = 12. 64, q =9. 65, all P lt; 0. 05] . Levels of FIB were significantly different among three groups ( F = 20. 592, P lt; 0. 05) while FIB in Group A[ ( 189. 98 ±5. 29) mg/ dL] and Group B[ ( 182. 70 ±2. 78) mg /dL] were significantly lower than that in Group C[ ( 198. 40 ±7. 37) mg/ dL, q = 4. 86, q= 9. 07, all P lt; 0. 05] , and FIB in Group A was significantly higher than that in Group B( q = 4. 20, P lt; 0. 05) . Levels of FⅧ were significantly different from each other( F = 33. 652, P lt;0. 05) while FⅧ in Group A[ ( 232. 26 ±4. 17) % ]and Group B[ ( 242. 53 ±14. 50) % ] were significantly lower than that in Group C[ ( 303. 25 ±32. 93) % ,q= 10. 73, q = 9. 18, all P lt; 0. 05] . Conclusions Pulmonary emphysema and hypercoagulable states increases with time and severity of SIH in rats with pulmonary emphysema. The elevated activity of blood coagulation factor may be a critical role in the hypercoagulable states.
Objective To summarize the advancement of hereditary thrombophilia. Methods Relevant literatures about hereditary thrombophilia published recently domestic and abroad were reviewed and analyzed. Results The hereditary risk factors of venous thromboembolism were different among different races. In western population, the main risk factors were activated protein C resistance (APC-R) and mutation of factor V Leiden, methylene tetrahydrofolate reductase polymorphism (C677T) and prothrombin G20210A. While in Chinese population, the disorder of protein C system and hyperhomocysteinemia were the major genetic risk factor. The existence of multiple genetic risk factors increased the incidence of primary and recurrent venous thromboembolism. Conclusion Further study on the relations between the hereditary risk factors and thrombophilia will be very important for prediction and prevention of the venous thromboembolism.
【Abstract】ObjectiveTo investigate the changes and significances of the activity of blood coagulation and fibrinolysis in hepatectomy patients accompanied with chronic hepatic disease. MethodsThirtyfive patients who were accompanied with cirrhosis undertook surgery in the second affiliated hospital of Chongqing Medicall University from year 2003 to 2004 were divided into two groups: the first group of 18 cases received hepatectomy and the second group received nonhepatectomy surgical treatment. The (prothrombin time PT), (activated partial thromboplatin time APTT), (thrombin time TT), and the content of (Fibrinogen Fbg) and (Ddimer DD) in the blood drawn from peripheral veins were quantitatively measured by a fullyautomatic chromogenic and immunological assay machine (ACLFutura 9000,USA) at the phases of before operation, right after operation and 24hour after operation, respectively. ResultsAPTT in hepatectomy group increased significantly (P＜0.01) and were much higher than the nonhepatectomy group at corresponding phases (P＜0.01). PT in hepatectomy group increased even more significantly compared with that of preoperation and right after the operation (P＜0.01). The differences of TT at varying phases in hepatectomy group were of no significance (Pgt;0.05). There was also no significant difference of PT, APTT, and TT in nonhepatectomy group at varying phases. ConclusionThe function of blood coagulation is relatively poor and the secondary activity of fibrinolysis is overactivated in hepatectomy patients accompanied with chronic hepatic disease, which indicates a high risk of hemorrhage.
Objective To show the changes of coagulation function in patients with esophageal carcinoma, and to explore the clinical significance of the changes. Methods We retrospectively analyzed the clinical data of 202 patients(as a trial group, 114 males, 88 females, aged from 36 to 69 years, median age at 49 years) with esophageal carcinoma confirmed by pathological examination in Gansu Provincial Hospital from January 2010 through May 2014. The prothrombin time (PT), prothrombin time activity (PTA), international activated partial thromboplastin time (APTT), fibrinogen (Fib), D-Dimer, and platelet count, pathological type, TNM stage, gender were recorded. Eighty patients (38 males, 42 females, with aged of 39 to 71 years, median age of 51 years) without cancer were selected as a control group. Results Compared with the control group, coagulation parameters including PT, APTT, PLT, Fib, TT, D-Dimer were statistically higher in the trial group (P<0.05). Higher Fib level was found in the squamous cell esophageal carcinoma patients than adenocarcinoma cell esophageal carcinoma patients (P<0.05). Fib increased significantly (P<0.05) and APTT shorten (P<0.05) in the patients at stage Ⅲ and stage Ⅳ compared with those of patients at stage Ⅰ and stage Ⅱ. Fib and D-Dimer levels increased (P<0.05) in N1-3 patients compared with those of N0 patients. There was no statistical difference in gender or age (P>0.05) between the two groups. Conclusion Most of the patients with esophageal carcinoma have abnormal changes of coagulation and fibrinolysis system. Patients with squamous subtype and/or lymph node metastasis at advanced stages of esophageal carcinoma are prone to thrombophilia. So monitoring the coagulation parameters of cancer patients can be used as an effective measure to prevent blood clot.