الفهرس 
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Abstract
Liver diseases are characterized by a reduce capacity of the liver to synthesize coagulation factors. Nowadays, the area of hypercoagulability in cirrhosis and its potential contribution to certain clinical aspects have received a lot of attention. The clinical manifestations of the hemostatic disorders of cirrhosis have been traditionally related to bleeding due tomultiple procoagulant factor defects, excessive fibrinolysis and thrombocytopenia. Routine coagulation tests, such as the PT and APTT, cannot evaluate the thrombotic tendency in cirrhosis. It has been shown that patients with cirrhosis display a procoagulant imbalance that may be detected by measuring thrombin generation.
This is a prospective case control study which was conducted at outpatient clinic of internal medicine dept., Minia University Hospital, Minia governorate, during the period from March to August 2017. A total of 80 subjects were included in this study, they were classified to three groups as follow:
• group (I): Control: Included 20 healthy subjects apparently healthy as a control group.
• group (II): Patients: Included 60 patients with chronic liver disease classified according to the severity of disease and child- Turcotte-pugh score into:
• group (II A): Included 20 patients with child-Pugh score A.
• group (II B): Included 20 patients with child- Pugh score B.
• group (II C): Included 20 patients with child- Pugh score C.
The aim of this study was to asses the function of blood coagulation in patients with chronic liver diseases and improve the knowledge of the pathophysiology of haemostasis.
The results are summarized as follow:
• The results revealed that group (II B) and group (II C) had significant higher number of cases with diabetes, HTN and blood transfusion and we noticed that higher number of cases was found in child score C (group, II C).
• group (II C) had significantly higher cases with Jaundice (100.0%) compared to other groups, also the same trend was found in ascites, LL odema, history of Hematemesis, history of Hep. Encephalopathy and splenomegaly and we noticed that the incidence of these findings increased with increase child score (disease severity). However, no significant difference was found among groups as regard liver size.
• Regarding liver enzymes (AST and ALT), group (II A) and (II B) had significantly higher level compared to control and group (II A). Serum albumin, Prothrombin time, and activated partial thromboplastin time (APTT) were increased significantly by increasing child score (disease severity), however, in contrast Prothrombin concentration was decreased. Regarding INR, group (II C) had significantly higher INR compared to the other three groups.
• Blood hemoglobin concentration was decreased significantly In group (II C) compared to other groups. While, platelets concentration was decreased significantly by increase child score. No significant differences were found among groups regarding WBCs concentration.