Journal of Clinical Hepatology
This article is based on a retrospective cohort of 1253 patients with primary liver cancer (including 991 with liver cirrhosis and 1055 with HBV infection), systematically analyzing thromboelastography (TEG) parameters (such as maximum amplitude MA, clot formation time K, coagulation angle α, etc.) in relation to the severity of liver disease (Child-Pugh classification, MELD score), liver reserve function (ICGR15), and traditional coagulation indicators. The results show that with the progression of liver cirrhosis, TEG indicates a hypocoagulable state (MA↓, K↑, α↓); while the MA and coagulation comprehensive index in the HBV infection group were significantly higher than those in the non-HBV group, showing a relative hypercoagulable tendency; MA is strongly positively correlated with platelet count and fibrinogen, and weakly negatively correlated with MELD/ICGR15. The study confirms that TEG is more sensitive than traditional indicators in reflecting the dynamic coagulation imbalance characteristics of liver cancer patients.
This study first confirms in a large sample that TEG can accurately distinguish the "hypocoagulable risk" caused by liver cirrhosis in liver cancer patients from the "hypercoagulable tendency" driven by HBV infection, breaking through the limitations of traditional coagulation tests (PT/INR/FIB) in the assessment of complex coagulation status. Its clinical value lies in providing an objective basis for individualized anticoagulation/anticoagulation decisions - such as being vigilant about bleeding in patients with MELD≥10 points, and strengthening thrombosis monitoring in patients with HBV-related high MA; at the same time, it expands the application path of TEG in perioperative management of liver disease, prevention of portal vein thrombosis, and prognosis assessment. This achievement promotes the transition of liver disease coagulation management from "empirical judgment" to "precise phenotypic typing", which is of important translational value in reducing perioperative complications of liver cancer and optimizing antiviral treatment strategies.
Objective: To investigate the clinical application value of thromboelastographic parameters in assessing coagulation function by analyz…
