Терапевтический архив (Feb 2009)
Regulators of fibrinolysis in chronic viral pathology of the liver
Abstract
Aim. To investigate a clinicopathogenetic role of fibrinolysis regulators in chronic viral hepatitis (CVH) and viral cyrrhosis of the liver (CL). Material and methods. Seventy patients entered the study: 10 patients with CVH B, 33 - with CVH C, 6 - with CVH D, 21 - with viral CL (HCV-associated in 14 cases and HBV-associated in 7 cases. A concentration and activity of tissue plasminogen activator (TPA), the level of plasminogen-1 activator inhibitor (PAI-1) in blood plasma were estimated with enzyme immunoassay (Technoclone GmbH, Austria). PAI-1/TPA was estimated. Results. Increased TPA, PAI-1 concentrations and TPA activity in plasma with maximal values in CL were found. Most severe imbalance in the system of fibrinolysis regulators occurs in poor-prognosis cirrhosis and decompensated portal hypertension. High TPA concentration and activity in CL have a positive correlation with the Child-Pugh index, while low PAI-1/TPA correlates negatively with this index. Conclusion. TPA and PAI-1 correlations with hemorrhagic manifestations and prognosis of the disease suggest an essential clinical role of fibrinolysis regulators in chronic viral pathology of the liver.
