Характеристика деяких показників системи гемостазу у хворих на компенсоване хронічне легеневе серце бронхо-легеневого генезу та особливості їх змін в умовах коморбідності зі стабільною ішемічною хворобою серця

Abstract

The purpose of the study was to research and analyze the peculiarities of changes of some hemostasis system indices and define their possible role in the formation of a vascular lesion in the patients with compensated chronic cor pulmolale of broncho-pulmonary genesis in conditions of its comorbidity with stable coronary heart disease. Materials and methods. The retrospective study and analysis of hemostasis system indices (platelet count, thrombin time, prothrombin time, antithrombin – III, plasma tolerance to heparin, plasmin lysis, fibrinogen, soluble fibrin) in 64 patients with chronic obstructive pulmonary disease and compensated chronic cor pulmonale (29 female, 35 male, mean age – 54.6 ± 2.3) were carried out. 32 patients with the isolated pathology formed the comparative group whereas 32 patients with the comorbid coronary heart disease (exertional angina, functional class II-III, postinfarction or aterosclerotic cardiosclerosis) 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 the presence of a significant increase of coagulation potential (the changes of indices of platelets, fibrinogen, plasma tolerance to heparin, antithrombin – III, and soluble fibrin) and activation of fibrinolysis system (thrombin time) and, simultaneous, its more pronounced depression (plasmin lysis) and increase of prothrombin time in case of presence of comorbid coronary heart disease in the patients with chronic cor pulmonale in conditions of chronic inflammatory process. Comorbidity promoted to the formation of disbalance of systemic correlation hemocoagulation and fibrinolysis. Our results confirm to a certain extent the following ideas of scientists: there are hypercoagulation and “exhaustion of the anticoagulant system potential” in case of combination of coronary heart disease and chronic obstructive pulmonary disease; hypercoagulation together with the oxidative stress and chronic systemic inflammation are general pathogenic mechanisms of chronic obstructive pulmonary disease and cardiovascular diseases, particularly of the coronary heart disease. Conclusion. The analysis of the changes of the hemostasis system indices in patients with compensated chronic cor pulmonale of broncho-pulmonary genesis indicates the presence of an increase of coagulation potential; the most significant changes with suppression of fibrinolytic activity are typical of the patients with comorbid coronary heart disease. The peculiarities of the hemostasis system changes in the patients with compensated chronic cor pulmonale of broncho-pulmonary genesis should be considered as a marker of the increased risk of the thrombogenic vascular complications. It should be taken into account for treatment-diagnostic strategy formation