| Budd-Chiari syndrome (B-CS) refers to posthepatic portal hypertension (PHT) and/or inferior vena cava hypertension caused by obstruction in outlet of major hepatic veins and/or posthepatic inferior vena cava. Though many kinds of causes about B-CS have been reported, they are uncompleted and indefinite. So the investigation of the etiology in B-CS is valuable and important especially to the clinical diagnosis and treatment. In recent years, many physicians have accepted the theory that the B-CS is not inborn but the sequels from the thrombosis. The hypercoagulation of patients with B-CS caused by many different causes, such as hyper-erythropoietin, colony-forming units erythroid and myoloproliferative disorder so on. And during the research of the thrombosis many physicians draw a conclusion that the increased quantity of vWF and GMP-140 is one of the most prevalent factors, which cause vein thrombosis. vWF is the specific molecule symbol of injury vascular endothelium cell and GMP-140 is the specific symbol of activation and release of platelets. But there have been few reports about the relation between the B-CS and theincreased quantity of vWF and GMP-140 now. To explore the causes of hypercoagulation and give theoretical support in clinical diagnosis and treatment, vWF and GMP-140 in patients with B-CS were investigated in this study.Materials and methods:60 patients in B-CS group including 42 patients (12~56years) with thrombus type B-CS (31 males and 11 females with the mean age of 29.6?.9 years), and 18 patients (26~49years) with membrane type B-CS (8 males and 10 females with mean age of 32.6?.2 years) were all diagnosed definitely with Color Doppler sonography and/or inferior vena cavography(IVCG) from June,2002 to Oct 2003 in Henan Provincial People's Hospital. In control group, there were 30 healthy persons (16~65years) including 16 males and 14 females, with mean age of 35.9?.8 years. Both vWF and GMP-140 were got form the vena blood plasma before and 2 weeks after the operation in B-CS group and during the health condition test in control group. The quantity of vWF and GMP-140 was measured with enzyme linked immunosorbent assay. And in B-CS group, the platelet was got from the vena blood and the number was measured with the normal method.Results:1. Before operation, the quantity of vWF and GMP-140 was (251.67 118.39)% and 87.92?4.47ng/mL in patients with B-CS, (256.73?124.49)% and 88.60?5.04 ng/mL in thrombus type B-CS, (239.85?03.82)%, and 86.32?6.46 ng/mL in membrane type B-CS, (112.25?6.61), and 24.90?.31 ng/mL in the controls. There was significant difference between B-CS group and control group (P0.01). The different quantity of vWF and GMP-140 between the thrombus type B-CS and the membrane type B-CS was not significant (P>0.05).2. Before operation, in patients with thrombus type B-CS, the number of platelet was (91 3 4) 109, and there was no significant correlation between the number of platelet and the quantity of vWF and GMP-140 (r=-0.1641 and -0.0369, P>0.05 ) . Therefore it is suggested that the injury of vascular endothelium and stimulation of platelet be the important factor in the formation of B-CS.3. Two weeks after operation, in patients with thrombus type B-CS, the quantity of vWF and GMP-140 was (248.36+113.43) % and 81.73?7.76ng/mL. There was no significant difference between the pre-operation and post-operation in patients with thrombus type B-CS (P>0.05). Therefore it is suggested that the operation should not change the hypercoagulation in patients with thrombus type B-CS. In patients with membrane type B-CS, the quantity of vWF and GMP-140 was (119.76?7.52) % and 41.33?2.30ng/mL.There was significant difference between the pre-operation and post-operation in patients with membrane type B-CS (P>0.05). Therefore it is suggested that the operation should change the hypercoagulation in patients with membrane type B-CS.Conclusions:1. Before operation, the patients with B-CS have higher quantity of vWF and GMP-140 than the controls, which indicate th... |
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