Application of prothrombin time (PT) in liver disease

Author: Succeeder    

Prothrombin time (PT) is a very important indicator to reflect liver synthesis function, reserve function, disease severity and prognosis. At present, the clinical detection of coagulation factors has become a reality, and it will provide earlier and more accurate information than PT in judging the condition of liver disease.

Clinical application of PT in liver disease:

The laboratory reports PT in four ways: prothrombintime activitypercentagePTA (prothrombin time ratio PTR) and international normalized ratio INR. The four forms have different clinical application values.

The application value of PT in liver disease: PT is mainly determined by the level of coagulation factor IIvX synthesized by the liver, and its role in liver disease is particularly important. The abnormal rate of PT in acute hepatitis was 10%-15%, chronic hepatitis was 15%-51%, cirrhosis was 71%, and severe hepatitis was 90%. In the diagnostic criteria of viral hepatitis in 2000, PTA is one of the indicators of clinical staging of patients with viral hepatitis. Chronic viral hepatitis patients with mild PTA>70%, moderate 70%-60%, severe 60%-40%; cirrhosis with compensated stage PTA>60% decompensated stage PTA<60%; severe hepatitis PTA<40%" In the Child-Pugh classification, 1 point for PT prolongation of 1~4s, 2 points for 4~6s, 3 points for >6s, combined with other 4 indicators (albumin, bilirubin, ascites, encephalopathy), the liver function of patients with liver disease Reserves are divided into ABC grades; MELD score (Modelfor end-stageliver disease), which determines the severity of the disease in patients with end-stage liver disease and the sequence of liver transplantation, the formula is .8xloge[bilirubin(mg/dl)+11.2xloge(INR)+ 9.6xloge[creatinine (mg/dl]+6.4x (cause: biliary or alcoholic 0; other 1), INR is one of 3 indicators.

DIC diagnostic criteria for liver disease include: PT prolongation for more than 5s or activated partial thromboplastin time (APTT) for more than 10s, factor VIII activity <50% (required); PT and platelet count are often used to evaluate liver biopsy and surgery The bleeding tendency of patients, such as platelets <50x10°/L, and PT prolongation exceeding normal for 4s are contraindications for liver biopsy and surgery including liver transplantation. It can be seen that PT plays an important role in the diagnosis and treatment of patients with liver disease.