Li_2005_Zhonghua.Nei.Ke.Za.Zhi_44_188

OBJECTIVE: To investigate the diagnostic value of coagulation factors in assessing the severity degree of liver cirrhosis caused by hepatitis B.
METHODS: Fifty-eight patients with liver cirrhosis and twenty healthy persons as control were enrolled. Prothrombin time activity percentage (PTA), activated partial thromboplastin time, coagulation activity of factor II, V, VII, VIII, IX and X were detected with clotting assay. Antithrombin-III (AT-III) was detected with colorimetric assay. The biochemical markers were also detected.
RESULTS: The differences of PTA, factor II, VII and AT-III among Child-Pugh A, B, C in patients with liver cirrhosis were statistically significant (P < 0.01). Through receiver operating characteristic curve analysis, when 64% and 50% were used as cut-off values for PTA and factor VII in diagnosing Child-Pugh B, the area under the curve (AUC) was 0.689 and 0.610, the sensitivity was 76.9% and 61.5%, the specificity was 62.2% and 55.6%; when 54% and 39% were used as cut-off values for PTA and factor VII in diagnosing Child-Pugh C, the AUC was 0.924 and 0.942, the sensitivity was 80.0% and 86.7%, the specificity was 88.4% and 90.7%. Stepwise linear regression was done between Child-Pugh grade and coagulation factors. PTA, cholinesterase (Che), total bilirubin (TBil), albumin (Alb), factor VII were included in regression equation, Y = 15.008 - 0.018 x PTA - 0.288 x Che + 0.264 x TBil - 0.988 x Alb - 0.034 x VII, R(2) = 0.871. Patients whose Y was less than 8 were classified as grade "a", between 8 - 10 as grade "b", more than 10 as grade "c", the diagnostic accuracy was 84.5%. CONCLUSION: Coagulation factor VII may serve as a helpful marker in diagnosing the severity degree of liver cirrhosis.