Изменения плазменной концентрации фактора Виллебранда и активности фактора VIII у больных гемобластозами с инфекционными осложнениями

Abstract

Infectious complications (IC) and sepsis are among the main causes of mortality in patients with haemoblastosis. The mechanisms of von Willebrand factor (vWF) involvement in inflammatory processes revealed in recent decades determine the possibility of its use as a marker of poor prognosis, along with factor VIII (FVIII), which closely interacts with vWF in the implementation of hemostasis and refers to the acute phase proteins. Objective. To determine the relationship of changes in vWF concentration and FVIII activity with mortality in IC of hemoblastoses. Material and methods. The study included 90 patients with haemoblastosis and IC in the intensive care unit. We assessed parameters necessary to calculate the SOFA score, C-reactive protein and procalcitonin content, coagulogram parameters, as well as vWF antigen concentration (vWF:Ag) and FVIII activity (FVIII:C). Results. Mortality in the study group was 35.5%, sepsis was diagnosed in 77 patients out of 90 (85.5%) included in the study. There was an increase in vWF:Ag to 361% (262–439) and FVIII:C to 373% (240–600). vWF:Ag was found to be significantly higher in the cohort of deceased patients than in survivors. vWF:Ag was found to correlate with C-reactive protein concentration, procalcitonin and the severity of organ disorders on the SOFA scale. Univariate and multivariate analysis revealed a predictive role of elevated vWF:Ag in the mortality prognosis in patients with IC along with D-dimer and antithrombin III concentrations. Conclusion. Increased vWF:Ag and FVIII:C are noted in patients with haemoblastosis and IC. Increased vWF:Ag, as well as increased D-dimer and decreased antithrombin III concentrations are independent mortality predictors in oncohematological patients with IC