肝病与弥散性血管内凝血（Liver disease and disseminated intravascular coagulation）.docVIP

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肝病与弥散性血管内凝血（Liver disease and disseminated intravascular coagulation）.doc

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肝病与弥散性血管内凝血（Liver disease and disseminated intravascular coagulation）

肝病与弥散性血管内凝血（Liver disease and disseminated intravascular coagulation） Liver disease and disseminated intravascular coagulation 2010-08-03 Xu Lizhuo Disseminated intravascular coagulation (DIC) in liver disease is common in severe liver disease or liver disease, with severe infection, endotoxemia, liver surgery, etc.. The lowest incidence rate of DIC was 2.8%, the highest was 41%, and the average rate was 8.8% to 16%. Without early diagnosis and early treatment, the mortality rate is very high. 1 DIC mechanism [1,2] 1.1 exogenous activation of coagulation system in liver disease, hepatitis viruses multiply and immune complexes generated continuously, resulting in extensive degeneration, edema and necrosis of liver cells, liver cells to release large amounts of tissue factor (TF), and the latter factor VII /F II a complex formation, activation of the extrinsic coagulation system. 1.2 endogenous coagulation system activation in liver disease, virus, endotoxin and immune complexes to damage vascular endothelial cells, resulting in the subendothelial collagen tissue exposure, activation of factor XII (F XII a). A and F XII activation of the kinin system, fibrinolysis system and endogenous coagulation system. 1.3 platelet activation is impaired by vascular endothelial cells. Platelets are adhered to endothelial tissue via von Willebrand factor (vWF), followed by platelet aggregation and release. Release of two adenosine monophosphate (ADP), 5- serotonin (5-HT) and beta platelet globulin (beta -TG), platelet fourth factor (PF4) and other active substances involved in the formation of micro thrombus. 1.4 anticoagulant factors reduced the synthesis of liver disease, such as anticoagulant antithrombin III (AT- III), protein C (PC), protein S (PS) and tissue factor pathway inhibitor (TFPI) and alpha 2- antiplasmin (alpha 2-AP) synthesis reduced, enhanced thrombin, plasmin and activity of activated coagulation factor. 1.5 endotoxemia, with the aggravation of liver disease, the