간경변증 환자에서 t - PA , Euglobulin 섬유소용해능 및 Protein C , S 의 변화와 식도정맥류출혈과의 관계

Background: Bleeding is common complication and a leading cause of death in cirrhotic patients, Accelerated fibrinolysis and coagulation inhibitor were contributing factors to bleeding. Method: In a study of 20 normal control and 20 liver cirrhosis (10 liver cirrhosis without esophageal variceal bleeding and 10 liver cirrhosis with esophageal variceal bleeding), we tried to evaluate fibrinolytic activity 8r inhibitory factors of the coagulation in liver cirrhosis and to find correlation between variceal bleeding and parameters of fibrinolysis % coagulation inhibitors. Results: 1) t-PA antigen was significantly increased(p <0.05) in patients with liver cirrhosis(22.2±12.5ng/ml) than in normal contro1(3.9±1.9ng/ml), but there was no statistically significant increase in cirrhotic patients with bleeding(26.2±13.8ng/ml) as compared to cirrhotic patients without bleeding(18.2±10.1ng/ml). 2) Euglobulin fibrinolytic activity was significantly higher(p<0,05) in patients with liver cirrhosis(145±37.6 BAU) than in normal control(91±7.8 BAU), but there was no statistically significant increase in cirrhotic patients with bleeding(150±64 BAU)as compared to cirrhotic patients without bleeding(131±22 BAU). 3) The activities of protein C was significantly lower(p<0.05) in patient with bleeding(41±9%) than in patient siwthout bleeding(54±18%). 4) The activities of protein S was lower in patient with bleeding(62±18%) than in patients without bleeding group(77±17%), but there was no statistical significance. 5) There was a significantly linear correlatian between t-PA antigen and euglobulin fibrinolytic activity in normal control and in patients with liver cirrhosis (r=0.807, p<0.01). Conclusion: Fibrinolytic activity(t-PA k euglobulin fibrinolytic activity) was increased in cirrhotic patients, but there was no statistically significant increase of fibrinolytic activity with relation to esophageal variceal bleeding. The activities of protein C was significantly decreased in liver cirrhosis with relation to esophageal variceal bleeding.