Rashin aiki na coagulation wani bangare ne na cutar hanta kuma mabuɗin mahimmanci a mafi yawan ƙididdiga.Canje-canje a cikin ma'auni na hemostasis yana haifar da zub da jini, kuma matsalolin zubar jini ya kasance babbar matsala ta asibiti.Abubuwan da ke haifar da zub da jini na iya zama kusan kashi (1) hauhawar jini na portal, wanda ba shi da alaƙa da tsarin hemostatic;(2) mucosal ko huda rauni zub da jini, sau da yawa tare da da wuri narkar da thrombus ko high fibrinolysis, wanda ake kira accelerated intravascular coagulation da fibrinolysis a cikin hanta cuta Melt (AICF).Hanyar hyperfibrinolysis ba a bayyana ba, amma ya haɗa da canje-canje a cikin coagulation na intravascular da fibrinolysis.Ana ganin coagulation mara kyau a cikin thrombosis portal vein thrombosis (PVT) da mesenteric vein thrombosis, da kuma zurfin jijiya thrombosis (DVT).Waɗannan sharuɗɗan asibiti galibi suna buƙatar magani ko rigakafi.Microthrombosis a cikin hanta da ke haifar da hypercoagulability sau da yawa yana haifar da atrophy hanta.
An bayyana wasu mahimman canje-canje a cikin hanyar hemostasis, wasu suna zubar da jini yayin da wasu sukan zubar da jini (Hoto 1).A cikin tsayayyen hanta cirrhosis, tsarin zai sake daidaitawa saboda abubuwan da ba a daidaita su ba, amma wannan ma'auni ba shi da kwanciyar hankali kuma wasu dalilai za su yi tasiri sosai, irin su girman girman jini, kamuwa da cuta, da aikin koda.Thrombocytopenia na iya zama mafi yawan sauye-sauyen cututtukan cututtuka saboda hypersplenism da raguwar thrombopoietin (TPO).Hakanan an bayyana tabarbarewar Platelet, amma waɗannan canje-canjen anticoagulant an daidaita su sosai ta hanyar haɓakar von Willebrand factor (vWF).Hakazalika, raguwar abubuwan da ke haifar da hanta, kamar abubuwan V, VII, da X, yana haifar da tsawan lokaci na prothrombin, amma wannan yana da matukar tasiri ta hanyar raguwar abubuwan da ke haifar da hanta (musamman furotin C).Bugu da ƙari, haɓakar endothelial-derived factor VIII da ƙananan sunadaran C suna haifar da yanayin hypercoagulable.Waɗannan canje-canjen, haɗe tare da tsinkayar jijiyar jijiyoyi da lalacewar endothelial (Virchow's triad), sun haifar da ci gaban haɗin gwiwa na PVT da DVT na lokaci-lokaci a cikin marasa lafiya tare da hanta cirrhosis.A takaice, hanyoyin hemostatic na hanta cirrhosis sau da yawa ana daidaita su ta hanyar da ba ta da kyau, kuma ana iya karkatar da ci gaban cutar ta kowace hanya.
Bayani: O'Leary JG, Greenberg CS, Patton HM, Caldwell SH.AGA Sabunta Ayyukan Clinical: Coagulation inCirrhosis.Gastroenterology.2019,157(1):34-43.e1.doi:10.1053/j.gastro.2019.03.070 .
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