[The clinical significance of plasma tissue plasminogen activator (t-PA) levels in severe acute or fulminant hepatitis]

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Year 1998

Hayashi T. Kobayashi Y. Yamaguchi K. Kamogawa A. Takahashi Y. Osada T. Tomoe M. Toyoma H. Yoshida H. Suzuki M. Iino S.

Second Department of Internal Medicine, St Marianna University, School of Medicine, Kawasaki.

We studied the tissue plasminogen activator (t-PA) levels in the plasma of patients with acute hepatitis (AH), severe acute hepatitis (AHs) and fulminant hepatitis (FH). Plasma t-PA levels were measured consecutively on the first, third and seventh days of hospitalization. Plasma t-PA levels were markedly higher in AHs and FH than in AH (p < 0.05, p < 0.01, respectively) on the first day, but did not differ significantly between AHs and FH on this day. The t-PA levels decreased markedly on the third and seventh days in AHs (both p < 0.05), but did not change from the first day to the third and seventh days in FH. The t-PA levels on the third and seventh days were higher in FH than in AHs (both p < 0.05). There was a significant increase in the plasma t-PA level before an episode of encephalopathy in FH compared with levels in AHs. These observations suggest that t-PA level may be useful as a prognostic parameter in patients with acute hepatic injury.