Abstract
Background: Coagulation abnormalities in patients with liver cirrhosis were occurred from impairments in the clotting and fibrinolytic systems, as well as from reduced number and function of platelets. This study was carried out to assess the haemostatic defects in patients of liver cirrhosis by estimating prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen level, fibrinogen degradation products (D-dimer), and platelet count.
Materials and Methods: This was a prospective observational study; it was carried out in Ibn-Sina hospital-Khartoum State. A total of 50 patients with cirrhosis of liver were selected from all age groups of both gender and 50 normal healthy individuals without liver disease or any disease affected the haemostatic mechanism were selected as control group. All the investigations were carried out in patients by standard procedures.
Results: The mean value of platelets count in patients with cirrhosis and controls group was 119000 ± 63000 and 220000± 40000 cells/ ul respectively, which was significantly lower in cirrhotic patients than the normal range of 150,000 - 4000,000 cell/ ul (p=0.04).
The mean value of PT was 27.82 ± 15.9 and 13.58 ± 0.57 seconds in patients with liver cirrhosis and control group respectively and the prolongation in cirrhotic patients was highly significant statistically (p<0.0001). The mean value of APTT was 52.76 ± 21.95 and 32.94 ± 1.31 seconds in patients with liver cirrhosis and control group respectively and the prolongation in cirrhotic patients was highly significant statistically (p<0.0001).Thirty-four out of fifty patients showed a serum fibrinogen level lower than normal 2-4g/l compared to controls had normal fibrinogen level with the mean value of 1.90 ± 1.30 and 2.9± 0.9g/L respectively, the difference from normal value was significant statistically (p=0.03). All patient of cirrhosis, showed raised level of D-dimer with the mean value 1500±500 ng/ml, whereas the controls showed normal level of D-dimer with the mean value150±30 ng/ml, the difference from normal value< 250 ng/ ml was significant statistically (p=0.002).
Conclusion: this study was concluded that Patients with cirrhosis were suffered from a complex haemostatic disturbance due to the pathogenetic mechanisms of the disease that had been showed by the prolongation of PT and APTT, thrombocytopenia, hypofibrinogenaemia and increased in D-dimer level.
