[The protease inhibitor treatment of the disseminated intravascular coagulation syndrome in patients with liver cirrhosis].

The results of the treatment of the syndrome of disseminated intravascular coagulopathy (DIC) in 41 patients with liver cirrhosis are reported. A relation between the severity of the liver impairment and the degree of the increase of the fibrin split products (FSP) was established. FSP above 100 micrograms/ml were found in patients with III class liver failure according to Child-Turcotte-Pugh and rating above 6.5 according to Z. Krŭstev. The administration of 30,000-60,000 U of the protease inhibitor contrykal led to mastering of the hemorrhagic diathesis in 19 of 21 patients (group A). The increased FSP in the serum fell (chi 2 = 5.79; p less than 0.001). In contrast, the administration of PAMBA and styptanon did not affect the hemorrhagic diathesis and DIC syndrome in 16 of 20 other patients (group B--chi 3 = 20.54; p less than 0.001). The authors recommend protease inhibitors as the treatment of choice of DIC syndrome in liver cirrhosis. Only in case of lack of effect should heparin be added.