Роль тромбоцитов как одного из маркеров активности инфекционного процесса у больных хроническим гепатитом С с обострением естественного течения болезни

Abstract

The purpose. To determine the role of Tr as one of the prognostic signs of the infectious process activation in case of exacerbation of the natural course of CHC at various periods of infection against the background of functional liver failure. Material and methods. 460 people (244 men and 216 women) were observed, divided into three groups depending on the number of Tr, according to the phases of disseminated intravascular coagulation syndrome (DIC): group I — hypercoagulation: Tr > 350 x 109/l, n = 36; group II — phase of multidirectional shifts: Tr 350–200 x 109/l, n = 148; group III — hypocoagulation: Tr < 200 x 109/l, n = 276, including patients with liver cirrhosis (n = 97) in the CHC outcome. We analyzed the number of Tr and their maximum amplitude (MA) of spontaneous aggregation in patients with an active infectious process, which is manifested clinically by indicators of liver functional tests (alanine aminotransferase, total bilirubin and its direct fraction, gamma-glutamyltranspeptidase, alkaline phosphatase, total protein, albumin) and the degree of fibrosis. Conclusion. The number and function of blood platelets in exacerbation of HCV are closely related not only to inflammation of the liver tissue, but also to the duration of infection, which is reflected in the manifestations of DIC syndrome. The longer the time of infection and the more active the infection process, the more pronounced the phase of hypocoagulation with a low Tr number, signs of cholestasis and fibrosis of the liver tissue. The relationship between the decrease in the number of platelets with impaired liver function tests and the severity of fibrosis is confirmed by the presence of correlations between them. Regardless of the phases of the DIC syndrome, an increase in the MA of spontaneous Tr aggregation is characteristic, especially expressed in the hypocoagulation phase.