Evaluation of Coagulation Parameters in Patients with Chronic Liver Diseases

Abstract

Chronic liver diseases are associated with secondary changes in primary and secondary hemostasis. Recently, many studies have reported that the plasma level of natural anticoagulants , such as antithrombin, are altered in patients with chronic liver diseases and are associated with the severity of the disease. The aim of this study is to evaluate different haemostatic parameters including antithrombin in patients with chronic liver diseases and to define the relationship between antithrombin level and the severity of chronic liver diseases. A case control study was conducted at Ibn Sena Teaching Hospital in Mosul for the period between 1st of October 2012 and 30th of April 2013. A total of 100 subjects were included in this study; 50 patients with chronic liver diseases and 50 age and sex matched healthy controls. Coagulation parameters of cases and controls measured and compared. A total of 50 cases were included in this study, 38 patients with cirrhosis and 12 patients with chronic hepatitis. In comparison with the controls, PT, APTT and showed significant prolongation and INR significantly prolonged (p < 0.001). The mean level of platelet count and fibrinogen were significantly reduced in patients with chronic liver disease (p < 0.001). The mean levels of antithrombin was significantly reduced in cirrhotic patients (p = 0.031) only, and no significant reduction was found in patients with chronic hepatitis. A statistically significant negative correlation were found between antithrombin level and Child-Pugh score (Pearson r = - 0.414, p = 0.01). In conclusion chronic liver diseases is associated with derangement in all haemostatic parameters. antithrombin reflects hepatocytes synthetic function of the liver and was supported by the negative correlation between antithrombin level and the severity of liver cirrhosis assessed by Child-Pugh score .