DOI: https://doi.org/10.26641/2307-0404.2015.3.53133

Peculiarities of coagulation hemostasis disorders in patients with chronic obstructive pulmonary disease.

V. H. Yakovlieva

Abstract


.The violation of blood coagulation properties is observed in many diseases of the respiratory system, including chronic obstructive pulmonary disease (COPD). It is known that in a stable COPD phase release of proinflammatory cytokines in blood is observed, it leads to disturbance of hemostasis parameters toward hypercoagulation. The aim of our study was to determine possibility of coagulation disorders formation in patients with COPD in a stable phase of pathological process at different stages of disease course and identify relationship between coagulation parameters levels and degree of violation of ventilation lung function. Materials and methods. We examined 30 patients with COPD in a stable disease phase, included in the main group (FEV1 =49,5±15,5%  of the due, there were 27 men (90.0%), 3 (30.0%) women, mean age was 61,8±7,9 years, level of pack /years index - 34,2±15,3). The control group consisted of 10 healthy subjects matched with the patients of the main group by age and sex. All patients were divided into 2 subgroups. Subgroup 1 included 16 patients with moderate COPD, that is the level of FEV1>50% (61,8±7,4% of predicted), and subgroup 2 - 14 COPD patients with severe COPD, that is the level of FEV1 <50% (35,3±8,2% of predicted). Patients received standard treatment according to the disease stage. Main indicators of coagulation levels: prothrombin index (PI), prothrombin ratio (PR), international normalized ratio (INR), activated partial thromboplastin time (APTT), thrombin time (TT) and antithrombin III (AT III) were identified in all patients. Results. The levels of PI, PR and INR in the subgroup 1 differed significantly from those of in the subgroup 2, control group (p<0,05) and pointed at hypercoagulation, whereas in the subgroup 2 all indicators were absolutely identical with control group. Correlation link between the level of INR levels and FEV1 (r=-0,73; p<0.01) in patients of the main group was determined. Levels of APTT, TT and AT III in the main group and in subgroups 1 and 2 were identical to those of the control group. There were no significant differences of these parameters between subgroups 1 and 2. Conclusions. In patients with COPD already at early stage of the disease abnormalities of coagulation hemostasis link mainly on external coagulation pathway toward hypercoagulation develop.


Keywords


chronic obstructive pulmonary disease; hemostasis; coagulation

Full Text:

PDF

References


Yakusheva EV et al. [Hemocoagulation changes in chronic obstructive pulmonary disease]. Uspekhi sovremennogo estestvoznaniya. 2008;5:160. Russian. 2. Dzyak GV. [Practical skills on hemostasiology. A training manual]. 2011:380. Ukraine. 3. Dobryans'kiy DV. [Hemorheology and immune disorders and their pharmacological correction with fen¬spirid in patients with chronic obstructive pulmonary disease]. Astma ta alergіya. 2011;1:28–31. Ukraine. 4. Dolgov VV, Svirin PV. [Laboratory diagnosis of disorders of hemostasis]. M: Triada; 2005:227. Russian. 5. Kovalenko SV, Dorofeev AE. [Fibrinolytic and proteolytic activity of the blood in patients with chronic obstructive pulmonary disease and asthma]. Ukraїns'kiy pul'monologіchniy zhurnal. 2012;3:35–37. Ukraine. 6. Lapach SN, Gubenko AV, Babich PN. [Statistical methods in biomedical research using Exel]. K: Morion. 2000;320. Russian. 7. Order of Ministry of Health of Ukraine N 555. 2013;83. Ukraine. 8. Rebrova OYu. [Statistical analysis of medical da¬ta. The use of the application package STATISTICA]. M: Me¬diaSfera. 2002;312. Russian. 9. Dzyublik YaA et al. [Features of hemostatic di¬sorders in elderly patients with chronic inflammatory lung di¬sease]. Ukraїns'kiy pul'monologіchniy zhurnal. 2002;4:58–61. Russian. 10. Lekka A. Dalamaga M, Triantafilli M et al. Cor¬relation of coagulation markers, platelet parameters and respiratory indexes in patients with chronic obstructive pulmonary disease. Haematologica. 2008;93:409. 11. Ashitani J, Mukae YA. Elevated plasma pro¬coagulant and fibrinolytic markers in patients with chronic obstructive pulmonary disease. Intern Med. 2002;41:181–5. 12. Fogarty AW, Lewis SA, McKeever TM et al. The Association Between Blood Coagulation Activity and Lung Function: A Population-Based Study. PLoS ONE. 2010;5(11):15014–5.


GOST Style Citations


1. Гемокоагуляционные сдвиги при хронической обструктивной болезни легких / Э.В. Якушева, О.С. Полунина, Л.П. Воронина, Т.В. Прокофьева // Успехи соврем. естествознания. – 2008. – № 5. – С. 160. 2. Дзяк Г.В. Практичні навички з питань гемо¬стазіології: нав.-метод. посіб. / Г.В. Дзяк. – Дніпро¬пет¬ровськ, 2011. – 380 с. 3. Добрянський Д.В. Гемореологічні та імунні порушення та їх медикаментозна корекція фенспі¬ридом у хворих на хронічне обструктивне захворю¬ван¬ня легень / Д.В. Добрянський // Астма та алергія. – 2011. – №1. – С. 28–31. 4. Долгов В.В. Лабораторная диагностика нару¬ше¬ний гемостаза / В.В. Долгов, П.В. Свирин. – М.: Триа¬да, 2005. – 227 с. 5. Коваленко С.В. Активність фібринолітичної та протеолітичної систем крові у хворих на хронічне обструктивне захворювання легень та бронхіальну астму / С.В. Коваленко, А.Е. Дорофєєв // Укр. пульмо¬нол. журнал. – 2012. – № 3. – С. 35–37. 6. Лапач С.Н. Статистические методы в медико-биологических исследованиях с использованием Exel / С.Н. Лапач, А.В. Губенко, П.Н. Бабич. – К.: Мо¬рион, 2000. – 320 с. 7. Про затвердження та впровадження медико-технологічних документів зі стандартизації медичної допомоги при хронічному обструктивному захво¬рюванні легень: наказ МОЗ України від 27.06.2013 № 555. – К., 2013. – 83 с. 8. Реброва О.Ю. Статистический анализ меди¬цинских данных. Применение пакета прикладних программ STATISTICA / О.Ю. Реброва. – М.: Ме¬диаСфера, 2002. – 312 с. 9. Особенности нарушений системы гемостаза у больных пожилого возраста, страдающих хроничес¬кими воспалительными заболеваниями легких / Я.А. Дзю¬б¬лик, Н.А. Морозова, Т.В. Яхница [та ін.] // Укр. пульмонол. журнал. – 2002. – № 4. – С. 58–61. 10. Correlation of coagulation markers, platelet parameters and respiratory indexes in patients with chronic obstructive pulmonary disease / A. Lekka, M. Dalamaga, M. Triantafilli [et al.] // Haematologica. – 2008. – Vol. 93. – P. 409. 11. Elevated plasma procoagulant and fibrinolytic markers in patients with chronic obstructive pulmonary disease. / J. Ashitani, H. Mukae, Y. Arimura [et al.] // In¬tern. Med. – 2002. – Vol. 41. – P. 181–185. 12. The Association Between Blood Coagulation Activity and Lung Function: A Population-Based Study / A. W. Fogarty, S. A. Lewis, T. M. McKeever [et al.] // PLoS ONE. – 2010. – Vol. 5, N 11. – Р. 15014 (5).




 

This work is licensed under a Creative Commons Attribution 4.0 International License