Karaciğer sirozunda hemostatik bozukluklar
Yükleniyor...
Tarih
2009
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
Attribution-NonCommercial 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Hemostatik bozukluklar, karaciğer hastalıklarında sık görülebilmekte ve bazen ciddi sonuçlara yol açabilmektedir. Bu çalışmada protrombin zamanı, aktive parsiyel tromboplastin zamanı, fi brinojen, fi brin yıkım ürünleri, faktör 7, 8 ve 9, transferin, haptoglobin, protein C, protein S, antitrombin III ve diğer bazı hematolojik parametrelerin karaciğer hastalığının düzeyi ile ilişkisi araştırılmıştır. Bu sonuçlara bağlı olarak karaciğer sirozlu hastalarda hematolojik bozuklukların ve hemostatik mekanizmalardaki değişikliklerin incelenmesi amaçlanmıştır. Bu çalışmaya karaciğer sirozu tanısı konan 44 hasta alındı. Hastaların 36’sı erkek, 8’i kadındı. Hastaların yaş ortalaması 43.2 yıl (31-76) idi. Spontan bakteriyel peritonit,
hepatoselüler karsinoma, hepatorenal sendrom ve kolestatik karaciğer hastalığı olan vakalar çalışmaya alınmadı. Hastalar 4’ü Child A, 20’si Child B, ve 20’si Child C olmak üzere 3 gruba ayrıldı. Yaş ortalaması A grubunda 39, B’de 54, C’de ise 45 yıl idi (p>0.05). Hastaların 40’ında (%90) HBV, 2’sinde HBV+HDV (%5) , 2’sinde ise (%5) alkole bağlı karaciğer sirozu mevcuttu. Gruplar arasında AST, ferritin, haptoglobulin, cinsiyet ve asit varlığı bakımından anlamlı fark mevcuttu (p<0.05). aPTZ, serum demiri ve transferin B ve C gruplarında benzerken, bu gruplar ile A grubu arasında anlamlı olmayan fark vardı (p>0.05). Gruplar arasında protrombin zamanı, faktör 7, 8 ve 9, protein C ve S, antitrombin III, fi brinojen, fi brin yıkım ürünleri, serum demir bağlama kapasitesi, hemoglobin, platelet, lökosit ve ortalama korpüsküler volüm bakımından fark bulunmadı (p>0.05). Sonuç olarak, karaciğer sirozu olan hastalarda hemostatik bozukluklar ile hastalığın aktivitesi ve klinik seyir arasında ilişki olduğu ve bu durumun hastalığın takip ve tedavisinde önemli olduğu söylenebilir.
In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classifi ed by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients. In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classifi cation. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fi brinogen, fi brin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classifi cation. There were signifi cant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p<0.05). In all groups there were abnormalities and dysfunctions in prothrombin time, fi brinogen, factor 8 and 9, serum iron, ferritin, transferrin, haptoglobin, protein C and S, anti-thrombin 3, hemoglobin and platelets, where there was no in activated partial thromboplastin time, fi brin degradation products, serum iron binding capacity, leucocytes and mean corpuscular volume (p>0.05). In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identifi cation of liver transplant candidiates earlier.
In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classifi ed by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients. In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classifi cation. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fi brinogen, fi brin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classifi cation. There were signifi cant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p<0.05). In all groups there were abnormalities and dysfunctions in prothrombin time, fi brinogen, factor 8 and 9, serum iron, ferritin, transferrin, haptoglobin, protein C and S, anti-thrombin 3, hemoglobin and platelets, where there was no in activated partial thromboplastin time, fi brin degradation products, serum iron binding capacity, leucocytes and mean corpuscular volume (p>0.05). In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identifi cation of liver transplant candidiates earlier.
Açıklama
Anahtar Kelimeler
Karaciğer sirozu, Hemostatik bozukluklar, Prognoz, Liver cirrhosis, Hemostatic abnormalities, Prognosis
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
36
Sayı
2
Künye
Yalçın, K. ve Ayyıldız, O. (2009). Karaciğer sirozunda hemostatik bozukluklar. Dicle Tıp Dergisi, 36(2), 127-133.
