ИЗУЧЕНИЕ КЛИНИКО-БИОХИМИЧЕСКИХ ПОКАЗАТЕЛЕЙ ПРИ МЫШЕЧНОЙ ПАТОЛОГИИ СРЕДИ БОЛЬНЫХ ГЕМОФИЛИЕЙ

Abstract

Aim. Determine the state of the biochemical composition of blood in the midst and resolution of muscle hematomas in patients with hemophilia.Materials and methods. 118 patients with hemophilia were examined. These patients were inpatient treatment at the hemophilia center at the Republican Specialized Scientific and Practical Hematology Center of the Ministry of Health of the Republic of Uzbekistan. The control group consisted of 40 apparently healthy men of the same age. Results. Signs of massive hemorrhages in the tissue are an increase in the blood level of the activity of the cytoplasmic enzyme aspartate aminotransferase (54.1 ± 3.9 and 18 ± 4.1, respectively) and alanine aminotransferase (55.3 ± 5.2 and 27.3 ± 4.4, respectively). Depending on the severity of the breakdown of muscle fibers and the rate of progression of the complication, the increase in CPK activity in myopathies can be either sharp - 680.7 ± 14.2 IU / L (hemophilic tumor, tissue necrosis), or, conversely, insignificant 120.3 ± 11.1 IU / L (muscle tissue contracture or atrophy). Deficiency of serum iron (6.4 ± 1.1 μmol / L) was revealed in all groups of examined patients with hemophilia. There was a tendency to lower cholesterol content to 3.3 ± 0.2 mmol / L. The content of urea, as the end product of protein metabolism, was higher in hemophilia patients with a syndrome of necrotic changes in hematomas – in 4 patients (9.8 ± 2.2 mmol / l), which, in our opinion, is associated with an increase in the breakdown of hemoglobin and other proteins with massive hemolysis of erythrocytes in tissues. The study of trace elements in the blood serum revealed a deficiency of Mg²+ 1.6 times, Ca²+ 2.1 times.Conclision. In patients with hemophilia with hemorrhages in muscle tissue, there was a tendency to lower cholesterol and iron levels, and an increase in the amount of bilirubin. The “key” enzymes for the diagnosis and prognosis of complications can be a dynamic study of the activity of the levels of CPK (creatine phosphokinase) and ALT (alanine aminotransferase), AST (aspartate aminotransferase).