Protein C pathway and antithrombin in thrombosis-related gastrointestinal disorders

Yıl 2010, Cilt: 9 Sayı: 2, 48 - 54, 01.08.2010

Hüseyin Alkım Selime Ayaz Canan Alkım Nurgül Şaşmaz

Öz

Background and Aims: We aimed to determine the frequency of activated protein C resistance and deficiencies of protein C, protein S and antithrombin in different gastrointestinal diseases (portal vein thrombosis, Budd-Chiari syndrome, liver cirrhosis, inflammatory bowel disease and gastrointestinal malignancies), which related with thrombosis etiologically and/or pathogenetically. Materials and Methods: Protein C, protein S and antithrombin activities were measured by functional methods. Activated protein C resistance was detected by the modified method using factor V-deficient plasma. Results: Protein C deficiency in the cirrhosis, malignancy and secondary portal vein thrombosis groups was significantly higher than in the other groups (p

Anahtar Kelimeler

Thrombosis, protein C, protein S, antithrombin, activated protein C resistance, portal vein thrombosis, Budd-Chiari syndrome, cirrhosis, inflammatory bowel disease

Trombozla ilişkili gastrointestinal hastalıklarda protein C yolağı ve antitrombin

Öz

Giriş ve Amaç: Etyolojisinde tromboz olan ve/veya doğal seyrinde
trombotik komplikasyonlarla sık karşılaşılan gastrointestinal hastalıklarda
(portal ven trombozu, Budd-Chiari sendromu, karaciğer sirozu, inflamatuar
barsak hastalığı ve gastrointestinal malignite) aktive protein
C direnci sıklığı ile protein C, protein S ve antitrombin eksikliklerini
araştırmak üzere bu prospektif çalışma planlandı. Gereç ve Yöntem:
Hastalardan fonksiyonel yöntemlerle protein C, protein S, antitrombin
aktiviteleri ve koagülasyon faktörü V’den yoksun test plazması kullanılarak modifiye yöntemle aktive protein C direnci araştırıldı. Bulgular:
Protein C eksikliği siroz, malign ve sekonder portal ven trombozu gruplarında
diğer gruplardan daha sıktı (p < 0.05). Primer portal ven trombozu
ve Budd-Chiari sendromundaki protein C eksikliği ise kontrolden
daha fazlaydı (p < 0.05). Protein S eksikliği Budd-Chiari sendromunda
diğer tüm gruplardan istatistiksel önemde fazlaydı. ‹nflamatuar barsak
hastalığı, malign ve her iki portal ven trombozu grubunda protein S eksikliği
oranı siroz ve kontrolden yüksekdi (p < 0.05). Antitrombin eksikliği
sirozda diğer tüm gruplardan daha fazlaydı. Aktive protein C direnci
varlığı oranı tüm hasta gruplarında kontrolden istatistiksel önemde
fazlalık gösteriyordu (p < 0.05). Budd-Chiari sendromunda aktive protein
C direnci bulunma oranı ise diğer tüm gruplardan fazlaydı (p < 0.05).
Ayrıca sirozlu ve maligniteli hastalarda tromboz varlığıyla aktive protein
C direnci bulunması korelasyon gösteriyordu (p < 0.05). Trombofilik
faktörlerden iki veya daha fazlasının birarada bulunması tromboz riskinde
belirgin artışa neden olmaktaydı. Sonuç: Protein C, protein S ve
antitrombin eksikliklerinin ve özellikle aktive protein C direnci varlığının; Budd-Chiari sendromu ve portal ven trombozu etyolojisinde rol oynayabileceği,
sirozlu, inflamatuar barsak hastalıklı ve maligniteli hastalarda
tromboz gelişme riskini arttırdığı saptandı.

Anahtar Kelimeler

Tromboz, protein C, protein S, antitrombin, aktive protein C direnci, portal ven trombozu, Budd-Chiari sendromu, siroz, inflamatuar barsak hastalığı

Kaynakça

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