gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLCgastro-j-1154Research ArticleГЕПАТОЛОГИЯHEPATOLOGYГиперкоагуляционный синдром у больных циррозом печениHypercoagulation syndrome at liver cirrhosisКуркинаИ. А.KurkinaI. A.

Куркина Ирина Александровна – заведующая кабинетом трансфузионной терапииКонтактная информация:

119991, Москва, ул. Погодинская, д. 1, стр. 1

Kurkina Irina A — head of transfusion therapy cabinet 

119991, Moscow, Pogodinskaya street, 1, bld. 1

kyrkinaia@rambler.ruМаевскаяМ. В.MayevskayaM. V.СилаевБ. В.SilayevB. V.ИвашкинВ. Т.IvashkinV. T.ГБОУ ВПО «Первый МГМУ им. И.М. Сеченова» Минздрава РоссииРоссияState educational government-financed institution of higher professional education «Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian FederationRussian Federation2014240420242463644Copyright © Куркина И.А., Маевская М.В., Силаев Б.В., Ивашкин В.Т., 20142014Куркина И.А., Маевская М.В., Силаев Б.В., Ивашкин В.Т.Kurkina I.A., Mayevskaya M.V., Silayev B.V., Ivashkin V.T.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/1154

Цель обзора. Представить современные данные о гиперкоагуляционном синдроме у пациентов с циррозом печени.Основные положения. Изменения в системе гемостаза у пациентов с циррозом печени имеют комплексный и неоднозначный характер. Суммарный эффект всех изменений зачастую сбалансирован, и система гемостаза остается функциональной. Однако сбалансированность системы у больных циррозом печени является неустойчивой. Постоянно существует потенциальный риск развития у них как кровотечений, так и тромботических осложнений.В качестве возможных причин, вызывающих тромбообразование, рассматриваются снижение уровня плазменных антикоагулянтов, повышение уровня фактора Виллебранда, снижение уровня протеазы ADAMTS13, изменения сосудистой стенки и снижение уровня профибринолитических факторов.Применение антикоагулянтов у пациентов с циррозом печени в настоящее время становится актуальной проблемой.Заключение. Больные циррозом печени характеризуются высоким риском как геморрагических, так и тромботических осложнений, поэтому им необходимо осуществлять углубленное исследование системы гемостаза. Назначение антикоагулянтной терапии таким пациентам должно базироваться на наличии доказанного тромбоза, отсутствии прямых противопоказаний, с учетом развития потенциальных осложнений антикоагулянтной терапии.

The aim of review

The aim of review. To present modern data on hypercoagulation syndrome at liver cirrhosis.

Key points

Key points. Changes in hemostasis system at liver cirrhosis have complex and ambiguous character. The total effect of all changes is frequently balanced, and the hemostatic system remains functional. However hemostasis equilibrium at liver cirrhosis is unstable. There is always potential risk of both hemorrhage and thromboses. As the possible reasons causing clotting, decrease of plasma anticoagulants level, elevation of von Willebrand factor level, decrease of ADAMTS13 protease level, changes of vascular wall and decrease of profibrinolytic factors level are taken into account. Application of anticoagulants for liver cirrhosis patients becomes an actual issue nowadays.

Conclusion

Conclusion. Patients with liver cirrhosis are distinguished by high risk of both hemorrhagic, and thrombotic complications, that requires profound investigation of hemostasis system. Prescription of anticoagulant therapy to such patients should be based on verified thrombosis, absence of direct contra-indications, considering risk of anticoagulant therapy complications.

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The authors declare that there are no conflicts of interest present.