{"title":"乙型肝炎相关肝硬化患者的纤维蛋白原功能障碍和纤维蛋白溶解状态。","authors":"Yu Liu, Yan Zhuang, Guanqun Xu, Xuefeng Wang, Lanyi Lin, Qiulan Ding","doi":"10.1080/16078454.2024.2392028","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the fibrinogen function in patients with hepatitis B-related cirrhosis and explore the relationship between dysfibrinogenemia and bleeding and thrombotic events.</p><p><strong>Methods: </strong>Medical records and laboratory data of the patients with hepatitis B-related cirrhosis were collected. Patients were categorized into three groups based on the Child-Pugh score. Fibrinogen activity and antigen, fibrinogen-bound sialic acid (FSA), fibrinogen polymerization and fibrinolysis kinetic analysis, thrombin-antithrombin complex (TAT) and plasmin-α<sub>2</sub>-antiplasmin complex (PAP) were detected.</p><p><strong>Results: </strong>Eighty patients with seventeen, thirty-eight and twenty-five in Child-Pugh A, B and C, respectively, were included. Seventeen patients experienced bleeding events and eight patients had thrombotic events. Fibrinogen activity and antigen levels were reduced with the severity of cirrhosis. Twenty-two patients exhibited dysfibrinogenemia. The FSA levels in patients with non-dysfibrinogenemia and those with dysfibrinogenemia were increased to 1.25 and 1.37 times of healthy controls, negatively correlated with fibrinogen activity (ρ = -0.393, <i>p</i> = 0.006). Compared to healthy controls, the amount of clot formation was reduced (<i>p</i> < 0.001), the polymerization was delayed (<i>p</i> < 0.001) and the rate of fibrinolysis was reduced (<i>p</i> < 0.001). The TAT levels were significantly increased in the Child-Pugh C patients compared to the Child-Pugh B patients (<i>p</i> = 0.032) while the PAP levels were comparable among 3 groups (<i>p</i> = 0.361).</p><p><strong>Conclusion: </strong>Sialylation of fibrinogen is one of the main causes of modifications of fibrinogen in patients with hepatitis B-related cirrhosis. The polymerization and fibrinolysis functions of fibrinogen are impaired. The degree of impaired fibrinolysis function is more severe than that of polymerization function, and may be partly related to the occurrence of thrombotic events.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Fibrinogen dysfunction and fibrinolysis state in patients with hepatitis B-related cirrhosis.\",\"authors\":\"Yu Liu, Yan Zhuang, Guanqun Xu, Xuefeng Wang, Lanyi Lin, Qiulan Ding\",\"doi\":\"10.1080/16078454.2024.2392028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the fibrinogen function in patients with hepatitis B-related cirrhosis and explore the relationship between dysfibrinogenemia and bleeding and thrombotic events.</p><p><strong>Methods: </strong>Medical records and laboratory data of the patients with hepatitis B-related cirrhosis were collected. Patients were categorized into three groups based on the Child-Pugh score. Fibrinogen activity and antigen, fibrinogen-bound sialic acid (FSA), fibrinogen polymerization and fibrinolysis kinetic analysis, thrombin-antithrombin complex (TAT) and plasmin-α<sub>2</sub>-antiplasmin complex (PAP) were detected.</p><p><strong>Results: </strong>Eighty patients with seventeen, thirty-eight and twenty-five in Child-Pugh A, B and C, respectively, were included. Seventeen patients experienced bleeding events and eight patients had thrombotic events. Fibrinogen activity and antigen levels were reduced with the severity of cirrhosis. Twenty-two patients exhibited dysfibrinogenemia. The FSA levels in patients with non-dysfibrinogenemia and those with dysfibrinogenemia were increased to 1.25 and 1.37 times of healthy controls, negatively correlated with fibrinogen activity (ρ = -0.393, <i>p</i> = 0.006). Compared to healthy controls, the amount of clot formation was reduced (<i>p</i> < 0.001), the polymerization was delayed (<i>p</i> < 0.001) and the rate of fibrinolysis was reduced (<i>p</i> < 0.001). The TAT levels were significantly increased in the Child-Pugh C patients compared to the Child-Pugh B patients (<i>p</i> = 0.032) while the PAP levels were comparable among 3 groups (<i>p</i> = 0.361).</p><p><strong>Conclusion: </strong>Sialylation of fibrinogen is one of the main causes of modifications of fibrinogen in patients with hepatitis B-related cirrhosis. The polymerization and fibrinolysis functions of fibrinogen are impaired. The degree of impaired fibrinolysis function is more severe than that of polymerization function, and may be partly related to the occurrence of thrombotic events.</p>\",\"PeriodicalId\":13161,\"journal\":{\"name\":\"Hematology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/16078454.2024.2392028\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/16078454.2024.2392028","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/2 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的评估乙肝相关肝硬化患者的纤维蛋白原功能,探讨纤维蛋白原血症与出血和血栓事件之间的关系:方法:收集乙肝相关肝硬化患者的病历和实验室数据。根据 Child-Pugh 评分将患者分为三组。检测纤维蛋白原活性和抗原、纤维蛋白原结合的硅酸(FSA)、纤维蛋白原聚合和纤维蛋白溶解动力学分析、凝血酶-抗凝血酶复合物(TAT)和plasmin-α2-antiplasmin复合物(PAP):纳入的 80 例患者中,Child-Pugh A、B 和 C 组分别有 17 例、38 例和 25 例。十七名患者发生了出血事件,八名患者发生了血栓事件。纤维蛋白原活性和抗原水平随着肝硬化的严重程度而降低。22名患者出现纤维蛋白原血症。非纤维蛋白原不良血症患者和纤维蛋白原不良血症患者的FSA水平分别增至健康对照组的1.25倍和1.37倍,与纤维蛋白原活性呈负相关(ρ = -0.393,p = 0.006)。与健康对照组相比,凝块形成量减少(p p p p = 0.032),而三组的 PAP 水平相当(p = 0.361):结论:纤维蛋白原的Sialylation是乙肝相关肝硬化患者纤维蛋白原发生改变的主要原因之一。纤维蛋白原的聚合和纤溶功能受损。纤溶功能受损的程度比聚合功能受损的程度更严重,这可能与血栓事件的发生有部分关系。
Fibrinogen dysfunction and fibrinolysis state in patients with hepatitis B-related cirrhosis.
Objective: To assess the fibrinogen function in patients with hepatitis B-related cirrhosis and explore the relationship between dysfibrinogenemia and bleeding and thrombotic events.
Methods: Medical records and laboratory data of the patients with hepatitis B-related cirrhosis were collected. Patients were categorized into three groups based on the Child-Pugh score. Fibrinogen activity and antigen, fibrinogen-bound sialic acid (FSA), fibrinogen polymerization and fibrinolysis kinetic analysis, thrombin-antithrombin complex (TAT) and plasmin-α2-antiplasmin complex (PAP) were detected.
Results: Eighty patients with seventeen, thirty-eight and twenty-five in Child-Pugh A, B and C, respectively, were included. Seventeen patients experienced bleeding events and eight patients had thrombotic events. Fibrinogen activity and antigen levels were reduced with the severity of cirrhosis. Twenty-two patients exhibited dysfibrinogenemia. The FSA levels in patients with non-dysfibrinogenemia and those with dysfibrinogenemia were increased to 1.25 and 1.37 times of healthy controls, negatively correlated with fibrinogen activity (ρ = -0.393, p = 0.006). Compared to healthy controls, the amount of clot formation was reduced (p < 0.001), the polymerization was delayed (p < 0.001) and the rate of fibrinolysis was reduced (p < 0.001). The TAT levels were significantly increased in the Child-Pugh C patients compared to the Child-Pugh B patients (p = 0.032) while the PAP levels were comparable among 3 groups (p = 0.361).
Conclusion: Sialylation of fibrinogen is one of the main causes of modifications of fibrinogen in patients with hepatitis B-related cirrhosis. The polymerization and fibrinolysis functions of fibrinogen are impaired. The degree of impaired fibrinolysis function is more severe than that of polymerization function, and may be partly related to the occurrence of thrombotic events.
期刊介绍:
Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.