Медицинская литература. Новинки

 

 

 

 

 

 

Эволюция взглядов и современные представления о состоянии системы гемостаза при циррозе печени

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Цель: изучить состояние отдельных звеньев системы гемостаза при циррозе печени по данным современной литературы. В обзоре представлен анализ данных литературы, освещающей состояние системы гемостаза при циррозе печени. В полемическом стиле изложены патофизиологические и патогенетические механизмы, лежащие в основе нарушений, возникающих в различных звеньях системы гемостаза при этом заболевании. Подвергнуты анализу литературные данные, касающиеся достаточно мало изученного аспекта цирроза печени - гиперкоагуляции. С позиции современных представлений и с учетом особенностей нарушений гемостаза постулирована патогенетическая значимость эндотелия сосудов и эндотелиальной дисфункции, а также роли медиаторов воспаления в развитии коагулопатии и синдрома внутрисосудистого свертывания крови у больных циррозом печени.

Ключевые слова:
печень, цирроз, гемостаз, фибринолиз, эндотелиальная дисфункция, тромбоз воротной вены, диссеминированное внутрисосудистое свертывание, liver, liver cirrhosis, hemostasis, fibrinolysis, endothelial dysfunction, portal vein thrombosis, disseminated intravascular coagulation

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Evolution of views and modern concepts of the state of the hemostasis system in liver cirrhosis

Aim. To study the state of individual elements of the hemostasis system in liver cirrhosis according to modern literature. Summary. The review presents an analysis of literature data covering the state of the homeostasis system in liver cirrhosis. The pathophysiological and pathogenetic mechanisms that underlie the disorders that occur in various parts of the hemostatic system in this pathology are described in a polemical style. Literature data concerning a relatively little-studied aspect of cirrhosis - hypercoagulation are analyzed. From the standpoint of modern concepts and taking into account the peculiarities of hemostasis disorders, the pathogenetic significance of the vascular endothelium and endothelial dysfunction is postulated. As well as the role of inflammatory mediators in the development of coagulopathy and intravascular coagulation syndrome in patients with cirrhosis of the liver.

Keywords:
печень, цирроз, гемостаз, фибринолиз, эндотелиальная дисфункция, тромбоз воротной вены, диссеминированное внутрисосудистое свертывание, liver, liver cirrhosis, hemostasis, fibrinolysis, endothelial dysfunction, portal vein thrombosis, disseminated intravascular coagulation