HEMOSTASIS UNBALANCE IN PUGH-SCORED LIVER-CIRRHOSIS - CHARACTERISTIC CHANGES OF PLASMA-LEVELS OF PROTEIN-C VERSUS PROTEIN-S

Liver cirrhosis leads to a protido-synthetic impairment that alters th e levels of blood clotting factors and haemostasis. The aim of this st udy was to assess the alterations of haemostatic parameters in the evo lution of liver cirrhosis scored according to Child's classification, with Pugh's modifications. Thirty-seven patients suffering from alcoho lic and non-alcoholic liver cirrhosis, representing stages A5, A6, B7, B8 and C10, were tested for the main blood clotting parameters, i.e. prothrombin time, factor VII, partial activated thromboplastin time, f ibrinogen, plasminogen, alpha2-antiplasmin and physiological inhibitor s [antithrombin III (ATIII), protein C (PC), protein S (PS)]. No varia tions were observed between substages A5 and A6 in any of the paramete rs, except for coagulation inhibitor levels. Most parameters showed a progressive decrease in stages B and C of the disease. The most signif icant alterations were found in the physiological coagulation inhibito rs, with a sharper decrease in PC and AT III level and a lesser decrea se in the level of PS through stages A5 and B8: this evidence could as sume an important biological and diagnostic significance.