[Fibrinolysis as a cause of coagulopathy in patients with chronic diffuse diseases of the liver]. / Fibrinoliz kak prichina koagulopatii u bolnykh khronicheskimi diffuznymi zabolevaniiami pecheni.

Examination was performed of 74 patients with chronic diffuse diseases of the liver; chronic active hepatitis, compensated hepatitis, decompensated cirrhosis of the liver (26, 28, 20 patients, respectively). Fibrinolysis was evaluated in relation to its effect on hemocoagulation. It appeared the principal cause of coagulopathy in 3% of the examinees. It is stated that activated fibrinolysis in chronic diffuse diseases of the liver underlies coagulopathy in few patients with decompensated cirrhosis, in compensated hepatopathy the influence of fibrinolysis on overall coagulative capacity of peripheral blood is insignificant.

[The mechanisms of disorders in the hemostatic system of patients with chronic diffuse liver diseases]. / Mekhanizmy narushenii sistemy gemostaza u bol'nykh khronicheskimi diffuznymi zabolevaniiami pecheni.

A total of 70 patients with chronic hepatitis and 60 with liver cirrhosis (LC) were examined. The hemorrhagic syndrome (HS) was identified in 16% of patients with chronic active hepatitis, in 26% with compensated and in 76% with decompensated LC. Intravital study of intravascular blood coagulation and liver microcirculation with the aid of fibrin determination according to D. D. Zerbino made it possible to establish local intravascular coagulation (LIC-syndrome). Study into the hemostatic and fibrinolytic systems, analysis of liver function, hemocoagulation and the intensity of the LIC-syndrome permitted one to arrive at conclusions about complex impairments of the hemostatic system in patients with chronic diffuse liver diseases characterized by a tendency towards blood hypocoagulation in the systemic blood flow with the risk of the development of the HS and a tendency towards hypercoagulation (with the risk of thrombosis development) in the vascular bed of the liver. It has been shown that the main cause of the HS occurring in chronic diffuse liver diseases lies in derangements of the thrombocytic component of the hemostatic system: thrombocytopenia as a consequence of hypersplenism and consumption of the most active thrombocytes in the process of the LIC. Activated fibrinolysis starts to exert an inhibitory action on hemocoagulation in patients with chronic diffuse liver diseases in the stage of decompensated LC. In compensated hepatopathies, the influence of fibrinolysis on coagulation and the development of the HS was immaterial.

[Prevention and treatment of hemostatic disorders in patients with liver cirrhosis]. / Profilaktika i lechenie narushenii gemostaza u bo'lnykh tsirrozom pecheni.

Disorders of the different links of the hemostatic system in patients with liver cirrhosis can be corrected by simultaneous prescription of minimal doses of heparin, vicasol and curantyl. As a result, treatment of liver cirrhosis, including cases with initial manifestations of the hemorrhagic syndrome, produced significant improvement of the hemostatic parameters and abatement of this syndrome. It is expedient to include this method in the combined treatment of this category of patients.

[Index of the functional state of the liver]. / Indeks funktsional'nogo sostoianiia pecheni.

A combination of laboratory tests, providing the most valuable quantitative assessment of hepatic function at large was selected with the aid of an EC-1020 computer on the basis of the investigation of 124 hepatic patients and 15 normal subjects. This combination was termed the hepatic functional index (HFI); it was determined by the PTI (prothrombin index) to RETk (blood Bengal rose retention) ratio, expressed as a percentage. Quantitative criteria of normal and abnormal hepatic activity, with subdivisions by severity, have been proposed on the basis of HFI estimations in patients with varying degrees of hepatic failure and in normal subjects.