Особливості змін деяких показників системи гемостазу у хворих на хронічне легеневе серце бронхо-легеневого генезу в стадії декомпенсації та в умовах його коморбідності з гіпертонічною хворобою

Abstract

The purpose of the study is to research and analyze the peculiarities of some indices of hemostasis system changes and define their possible role in the formation of a vascular lesion in the patients with chronic cor pulmolale of broncho-pulmonary genesis during decompensating stage and in conditions of its comorbidity with hypertensive disease. Materials and methods. The retrospective study and analysis of indices of hemostasis system (platelet count, thrombin time, prothrombin time, antithrombin - III, plasma tolerance to heparin, plasmin lysis, fibrinogen, soluble fibrin) in 96 patients with chronic obstructive pulmonary disease and decompensated chronic cor pulmolale with signs of circulatory insufficiency of the 2nd stage (female – 34, male – 62, mean age – 57.5±1.2) were carried out. 32 patients with the isolated pathology formed the comparative group whereas 64 patients with the comorbid hypertensive disease of the 2nd stage, of the 2nd degree of arterial hypertension, built the main group. The obtained research results of the patients of the main and comparative groups were compared both in groups and with the indices of practically healthy individuals (n = 15) of the same gender and age. Results and discussion. The obtained results indicated to a certain extent the presence of a significant increase of coagulation potential, an increase of fibrinolysis system activity and the disorder of “external way” of blood coagulation. It doesn’t exclude the change of procoagulant factors content/activity and can be considered as a result of their intensive using. The foregoing changes were the most significant (it concerns all indices) in the patients with chronic cor pulmolale and comorbid hypertensive disease. Our results confirm to a certain extent the following idea of scientists. Hypercoagulation and activation of the platelets together with the chronic systemic inflammation and oxidative stress are general pathogenic mechanisms of chronic obstructive pulmonary disease and cardiovascular diseases, particularly of the arterial hypertension. It is reflected clearly as a very important constituent part of “mutual burden” syndrome in case of a comorbid course. Conclusion. The peculiarity of the hemostasis system changes in patients with decompensated chronic cor pulmolale of broncho-pulmonary genesis is an increase of its coagulation potential; the most significant its manifestations with activation and simultaneous suppression of fibrinolytic activity are typical of the patients with the comorbid hypertensive disease (it can be considered as manifestations of the chronic disseminated intervascular coagulation syndrome). The increased coagulation potential of a hemostasis system in the patients with decompensated chronic cor pulmolale of broncho-pumonary genesis should be considered as a marker of the risk of the thrombogenic vascular complications development; it is necessary to carry out the periodical monitoring of its indices with the purpose of prevention of the development of cardiovascular events both in the isolated course of chronic cor pulmolale and in the conditions of comorbidity with hypertensive disease