Trombomodulin’in sisplatinli kemoterapi alan hastalarda koagulasyona eğilimin artmasındaki rolü
Küçük Resim Yok
Tarih
2008
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sitotoksik kemoterapilere bağlı gelişen koagulasyona eğilimin nedenlerinden birisi de, endotel hücresi hasarı olabilir. Gerçek mekanizması tam olarak bilinmemektedir. Trombomodulin intravaskuler koagulasyonun önemli bir modülatörüdür. Bircok endotel hücresi ve tümör hücresi üzerinde bulunur. Bu çalışmada, sisplatin kullanımı sonucu gelişen vasküler toksisite ve endotel hasarına bağlı olarak artan koagulasyona eğilimde, F-VIII, vWF, diğer koagulasyon faktörleri ve TM düzeyinin, bir gösterge olup olmadığı araştırıldı. Tedavi öncesi ve tedaviden sonraki 12 ile 24. saatler arasında olmak üzere, iki kez venöz kan alındı. PT, aPTT, TT, fibrinojen, D-Dimer, F-VIII ve trombomodülin düzeylerine bakıldı. 27 hastanın TM duzeyleri tedavi öncesi (TMO ) ortalama 47.7 } 24.8 g/ml (22-130) g/ml, tedavi sonrası ise (TMS) ortalama 39,7 } 19,5 g/ml (18-96) g/ml olup, aralarında anlamlı farklılık saptanmadı.Trombin zamanı (TT) (P0.02) ve fibrinojenin (P0.005 ) tedavi öncesi ve sonrası değerleri arasında anlamlı fark saptandı. Vaka sayısı arttırılarak yapılacak çalışmalarda plazma çözünebilir TM düzeyinin endotel hasarının belirleyicisi olabileceği gosterilebilir. Parametrelerde tedavi sonrası olması beklenen değişikliklerin anlamlı düzeyde görülmemesi, vaka sayısının yetersizliğine bağlandı.
One of the reason why chemotherapeutics cause increased intencity to coagulation may be the endotelial damage. The exact mechanism is not known clearly. Trombomodulin is an important modulater of inravascular coagulation and is available on many of the endotelial, tumors. In this study the effect of F-VIII, vWF other coagulation factors and thrombomoduline in the increased coagulation due to vasculary toxicity and endothelial damage after cisplatin administration were evalutaed. Venous blood samples were taken from the patients before treatment and between 12 and 24 hours after treatment. PT, aPTT, TT, fibrinojen, D-Dimer, F-VIII and thrombomodulin levels were measured. TM levels before and after chemotherapy were measured in 27 of 28 patients. Mean TM level before treatment (TMBT) was 47.7 ±} 24.8 ng/ml (22-130 ng/ml) and mean TM level after treatment (TMAT) was 39.7 ±} 19.5 ng/ml (18-96 ng/ml). The difference was not significant. The diffrence of pre and post treatment levels of TT (P0.02) and fibrinogen (P0.005 ) were significant. The researches with more patients included, may reveal TM level as a sign of endothelial toxicity. The expacted changes in the parameters after treatment were not significant as thought to be related with the inadequate number of patients.
One of the reason why chemotherapeutics cause increased intencity to coagulation may be the endotelial damage. The exact mechanism is not known clearly. Trombomodulin is an important modulater of inravascular coagulation and is available on many of the endotelial, tumors. In this study the effect of F-VIII, vWF other coagulation factors and thrombomoduline in the increased coagulation due to vasculary toxicity and endothelial damage after cisplatin administration were evalutaed. Venous blood samples were taken from the patients before treatment and between 12 and 24 hours after treatment. PT, aPTT, TT, fibrinojen, D-Dimer, F-VIII and thrombomodulin levels were measured. TM levels before and after chemotherapy were measured in 27 of 28 patients. Mean TM level before treatment (TMBT) was 47.7 ±} 24.8 ng/ml (22-130 ng/ml) and mean TM level after treatment (TMAT) was 39.7 ±} 19.5 ng/ml (18-96 ng/ml). The difference was not significant. The diffrence of pre and post treatment levels of TT (P0.02) and fibrinogen (P0.005 ) were significant. The researches with more patients included, may reveal TM level as a sign of endothelial toxicity. The expacted changes in the parameters after treatment were not significant as thought to be related with the inadequate number of patients.
Açıklama
Anahtar Kelimeler
Onkoloji
Kaynak
Uluslararası Hematoloji-Onkoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
18
Sayı
2
