Akut koroner sendrom olgularında yapışkan trombosit sendromunun rolünün belirlenmesi
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Dosyalar
Tarih
2009
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Tromboembolizm gelişmiş ülkelerde önde gelen morbidite ve mortalite nedenidir. Tanımlanmış hiperkoagülabilitesi olan hastaların yarıdan fazlasında doğumsal veya edinsel koagülasyon veya trombosit bozukluğu bulunur. Yapışkan trombosit sendromu adenozin difosfat ve/veya epinefrine karşı in vivo trombosit hiperreaktivitesi ile karakterize doğumsal bir trombosit bozukluğudur. Yapışkan trombosit sendromu birçok arteryel ve venöz trombozdan sorumlu olan, sık rastlanan, tanı ve tedavisi kolay bir trombosit bozukluğudur. Çalışmamızın ilk basamağında yapışkan trombosit sendromu'nun tanımlanmasında kullanılan farklı konsantrasyonlarda adenozin difosfat ve epinefrin uyarısı sonrası kendi laboratuvarımızın normal agregasyon ve sekresyon değerlerini saptadık. Daha sonra akut koroner sendrom öyküsü olan ve anjiografik olarak koroner arterleri hastalarda yapışkan trombosit sendromu'nun rolünü bulmaya çalıştık. Trombositlerin agregasyon ve sekresyon reaksiyonları lümiagregometri yöntemi kullanılarak eş zamanlı kaydedildi. Çalışmamıza 49 sağlıklı kontrol ve akut koroner sendrom tanılı 23 hasta dahil edildi. 7 (%30) hastada yapışkan trombosit sendromu saptandı. Biri hariç tüm agonist konsantrasyonlarında agregasyon ve sekresyon yanıtları arasında anlamlı korelasyon izledik. Bulgularımız agregasyon ve sekresyon bağlamında trombosit hiperreaktivitesinin global bir fenomen olduğunu ve seçilmiş hasta grubumuzda yapışkan trombosit sendromu'nun sık rastlanan bir bozukluk olduğunu gösterdi.
Abstract
Thromboembolism is the leading cause of morbidity and mortality in developed countries. More than half of patients with defined hypercoagulability have a hereditary or aquired coagulation or platelet disorder that caused thrombosis. The sticky platelet syndrome is a hereditary platelet defect characterized with increased in vivo platelet hyperreactivity to adenosine diphosphate and/or epinephrine . Sticky platelet syndrome is a common, easy to diagnose and easy to treat platelet defect that is responsible for many arteriel and venous thrombotic events. At first step of our study we found normal aggregation and secretion ranges of our own laboratory after stimulation with different concentrations of adenosine diphosphate and epinephrine which was used to define sticky platelet syndrome . Thereafter we tried to find out the role of sticky platelet syndrome among patients with a history of acute coronary syndrome and angiographically normal coronary arteries. Aggregation and secretion reactions of platelets were recorded at the same time using lumiaggregometric method. Our study included 49 healty controls and 23 patients with acute coronary syndrome. 7 (30%) patients were found to have sticky platelet syndrome. We observed significant correlation between aggregation and secretion responses on all but one agonist concentrations. Our findings indicate that platelet hyperreactivity could be a global phenomenon in terms of aggregation and secretion, and sticky platelet syndrome is a common defect in our selected patient population.
Abstract
Thromboembolism is the leading cause of morbidity and mortality in developed countries. More than half of patients with defined hypercoagulability have a hereditary or aquired coagulation or platelet disorder that caused thrombosis. The sticky platelet syndrome is a hereditary platelet defect characterized with increased in vivo platelet hyperreactivity to adenosine diphosphate and/or epinephrine . Sticky platelet syndrome is a common, easy to diagnose and easy to treat platelet defect that is responsible for many arteriel and venous thrombotic events. At first step of our study we found normal aggregation and secretion ranges of our own laboratory after stimulation with different concentrations of adenosine diphosphate and epinephrine which was used to define sticky platelet syndrome . Thereafter we tried to find out the role of sticky platelet syndrome among patients with a history of acute coronary syndrome and angiographically normal coronary arteries. Aggregation and secretion reactions of platelets were recorded at the same time using lumiaggregometric method. Our study included 49 healty controls and 23 patients with acute coronary syndrome. 7 (30%) patients were found to have sticky platelet syndrome. We observed significant correlation between aggregation and secretion responses on all but one agonist concentrations. Our findings indicate that platelet hyperreactivity could be a global phenomenon in terms of aggregation and secretion, and sticky platelet syndrome is a common defect in our selected patient population.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Yapışkan Trombosit Sendromu, Akut Koroner Sendrom, Sekresyon, Trombosit, Hiperreaktivite, Sticky Platelet Syndrome, Acute Coronary Syndrome, Secretion, Platelet, Hyperreactivity
