Changes in procoagulant and anticoagulant factors in patients with hepatitis B cirrhosis

• Main Author: DENG Yongdong
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2019-02-01
• Series: Linchuang Gandanbing Zazhi
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=9600
• ISSN: 1001-5256; 1001-5256

Objective To investigate the changes in procoagulant and anticoagulant factors and routine coagulation markers in patients with hepatitis B cirrhosis and their clinical significance. Methods A total of 105 patients with hepatitis B cirrhosis who were admitted to Department of Infectious Diseases in The First Hospital of Lanzhou University from January 2017 to October 2018 were enrolled, and according to the Child-Pugh class, these patients were divided into group A (42 patients with Child-Pugh class A cirrhosis), group B (39 patients with Child-Pugh class B cirrhosis), and group C (24 patients with Child-Pugh class C cirrhosis). Routine coagulation markers including prothrombin time (PT) and activated partial prothrombin time (APTT), blood coagulation factors (Ⅱ,Ⅴ, Ⅶ, Ⅷ, and Ⅺ), anti-thrombin (AT), protein C (PC), and free protein S (FPS) were measured for all patients. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; a Spearman correlation analysis was also performed. Results There were significant differences in PT and APTT between the three groups (F=55.11 and 12.09, both P＜0.001); group C had significantly higher PT and APTT than groups A and B, and group B had significantly higher PT and APTT than group A (all P＜0.05). There were significant differences in the activities of blood coagulation factors Ⅱ, Ⅴ, Ⅶ, and XI between the three groups (F=32.52, 14.77, 38.88, and 9.24, all P＜0.001); group C had significantly lower activities of these coagulation factors than groups B and A, and group B had significantly lower activities than group A (all P＜0.05). There was a significant difference in the activity of blood coagulation factor Ⅷ between the three groups (F=4.44, P＜0.05); group C had a significantly higher activity than groups A and B (P＜0.05), while there was no significant difference between group A and group B (P＞0.05). There were significant differences in the activities of AT, PC, and FPS between the three groups (F=25.90, 30.46, and 15.58, all P＜0.001); group C had significantly lower activities than groups B and A, and group B had significantly lower activities than group A (all P＜0.05). The correlation analysis showed that Child-Pugh class was negatively correlated with blood coagulation factors Ⅱ, Ⅴ, Ⅶ, and Ⅺ and anticoagulant factors PC, FPS, and AT (r=-0.687, -0.460, -0.706, -0.426, -0.723, -0.646, and -0.468, all P＜0.001), and Child-Pugh class had the strongest correlation with blood coagulation factors Ⅱ and Ⅶ and the anticoagulant factor PC. Blood coagulation factors II and Ⅶ were positively correlated with the anticoagulant factor PC (r=0.851 and 0.745, both P＜0.001). Conclusion Patients with hepatitis B cirrhosis have reductions in both procoagulant and anticoagulant factors, and there is a significant correlation between them. An unstable balance may form in the body, which is not considered a conventional hypocoagulable state.