Pathogenesis and clinical characteristics of the Budd–Chiari syndrome (BCS) in Asia are somewhat different fromthe ones observed in Western countries. Obstruction of theinferior vena cava (IVC) or of the hepatic veins is caused to agreater extent by membranous webs than by thrombosis.Impaired fibrinolysis has been found in European patientswith BCS, but its status in Chinese patients with thiscondition is still unknown. To explore the characteristics offibrinolysis in BCS patients in this country, we measured the euglobulin lysis time (ELT) for overall fibrinolysis and theplasma levels of five fibrinolytic components in 65 Chinesepatients with BCS and 43 healthy controls. In patients, ELTswere slightly shorter than in controls (mean, 293 vs. 357 min,P<0.02), tissue type plasminogen activator levels werehigher than in controls (mean, 239 vs. 185 pg/ml, P<0.01),and plasminogen activator inhibitor 1 levels were lower than in controls (mean, 1.43 vs. 1.73 ng/ml, P<0.001). To exploreBCS in more detail, we subgrouped the cases according toage, type of venous occlusion, Child-Pugh score, andthrombosis. As a result of this analysis, we found that youngpatients (age <30 years) had a longer ELT (mean, 440 min)than the older patient groups (30<— age<— 44, 45<— age<— 54,age>54 years; mean ELTU242, 198, and 289 min,respectively, all P<0.05). The independent hepatic veinocclusion subgroup showed a longer ELT (mean, 367 min)than the combined hepatic vein and IVC or the independentIVC occlusion subgroup (mean ELTU233 and 260 min, bothP<0.05). ELT did not show significant differences betweenChild-Pugh class A and B subgroups (mean, 267 vs. 333min, P>0.05). ELT in the subgroup without thrombosis was shorter than in controls (mean, 288 vs. 358 min, P<0.05),and in the subgroup with thrombosis, it was also slightlyshorter than in controls, without reaching statisticalsignificance (mean, 306 vs. 358 min, P>0.05). By and large,overall fibrinolytic potential was slightly increased inChinese patients with BCS in this study, but fibrinolysisdiffered according to its baseline characteristics. Comparedwith the one seen in BCS patients from Western countries,BCS in China exhibits certain special changes in fibrinolysisand we were able to explain some of these changes. BloodCoagul Fibrinolysis 25:000–000 2014 Wolters KluwerHealth | Lippincott Williams & Wilkins.
江莱生物产品文献:Fibrinolysis status in the Budd–Chiari syndrome in China.pdf