assessment of coagulation parameters in liver cirrhosis

ABSTRACT

This study was carried out to assess the haemostatic defects in patients of liver cirrhosis by estimating prothrombin time [PT], activated partial thromboplastin time [APTT], plasma fibrinogen level, fibrinogen degradation products [D-dimer], and platelet count. It was carried out at the Department of Pathology, King Edward Medical College, Lahore. A total of 50 patients from all age groups of both gender with cirrhosis of liver were selected from Mayo Hospital, Lahore. All the investigations were carried out by standard procedures. Results were analyzed statistically with appropriate tests of significance. The mean values of PT and APTT were 14 second and 19 seconds longer than the control values respectively. These prolongations were highly significant statistically [p<0.0001]. Thirty-four out of fifty patients showed a serum fibrinogen level lower than normal with the mean value of 1.90 +/- 1.30 g/L The difference from normal value was not significant statistically. All but one patient of cirrhosis, sho wed raised level of D-dimer i.e.>250 ng/ml. Mean platelet count in patients was significantly lower than normal value [p<0.05]. Prolongation of PT and APTT indicates plasma clotting factors deficiency due to impaired hepatic synthesis. Derangements of other coagulation parameters indicate that multiple factors like fibrinolysis, hypofibrinogenaemia, thrombocytopenia, and low grade DIC, all play a role in liver cirrhosis