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High circulating D-dimers are associated with ascites and hepatocellular carcinoma in liver cirrhosis

世界胃肠病学杂志：英文版 2008年第10期14卷 1549-1552页

作者： Aldo Spadaro Vincenza Tortorella Carmela Morace Agostino Fortiguerra Paola Composto caterina bonfiglio Angela Alibrandi Carmelo Luigiano Giuseppe De Caro Antonino Ajello Oscar Ferraù Maria Antonietta Freni Department of Medicine and Pharmacology University Hospital Messina 98125 Italy Department of Statistics University oMessina Messina 98125 Italy

AIM: To measure plasma D-dimer levels in cirrhotic patients with and without ascites, assessing the effect of ascites resolution in D-dimer concentration. METHODS: Seventy consecutive cirrhotic patients (M = 44, F = 26, mean age 65 years, SD ± 13), observed from October 2005 to March 2006 were enrolled. Circulating D-dimer levels were measured using a latex-enhanced, immunoturbidimetric test. In patients with ascites (n = 42) the test was repeated after ascites resolution. RESULTS: Ascites was present in 42 patients (group A) and absent in 28 (group B). Group A patients had more advanced liver disease. Hepatocellular carcinoma (HCC) was diagnosed in 14 patients and was more frequent in group B. Above normal range D-dimers were found in 45/70 patients. High D-dimers were more frequent in group A than in group B (P = 0.001). High D-dimers were associated with presence of HCC (P = 0.048) only in group B. After ascites resolution, obtained in all patients, mean D-dimer values decreased in those 34 patients with high basal levels (P = 0.007), returning to normal in 17. CONCLUSION: In patients with liver cirrhosis, ascites and HCC are the main factors associated with increased fibrinolytic activity.

关键词：肝细胞癌肝硬化腹水 D-二聚物

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