Репозиторий Университета

© 2018, Dynasty Publishing House. All rights reserved. The objective. Based on revealed changes in the parameters of the blood coagulation system and the functional state of the endothelium to propose pathogenetically justified therapeutic and diagnostic approaches ensuring a higher effectiveness of therapy of inflammatory bowel disease and prevention of complications. Patients and methods. We examined 78 children aged 3 to 15 years with newly diagnosed IBD, standard gastroenterological examination was performed to determine specificities of the coagulation system of IBD patients with administration of tests characterizing the state of all its components (number, size and aggregation of platelets, von Willebrand factor, international normalised ratio, activated partial thromboplastin time, thrombin time, fibrinogen, D-dimer, nitric oxide). Results. In the course of the study we found disorders in all components of the coagulation system. During exacerbation in children with ulcerative colitis and Crohn’s disease total concentrations of nitrates and nitrites in blood increase, in UC a reduced capability of the initial stage of thrombus formation with regard to the parameter «degree of platelet aggregation» can be found, which might account for frequent bleedings in this pathology. In CD, a significant decrease of platelet aggregation size was found, which is indicative of impaired functional properties of platelets. Investigating the coagulation component we found disorders of the final state of hemostasis – a prolonged time of fibrin clot formation resulting from prolonged TT, and also higher levels of D-Dimer, which is indicative of increased fibrinosysis processes. After alleviation of disease exacerbation the coagulation parameters only partially normalised: deviations in the platelet component remained. Conclusion. The processes of intestinal wall inflammation and disorders of the blood coagulation system in IBD exacerbation and in the course of its alleviation run parallel to each other. A developed clinical picture of IBD is accompanied by disorders of the initial (thrombus formation) and final (increased fibrinosysis) stages of blood clotting. A decreased degree and quality of platelet aggregation, increased fibrinosysis are evidently an important pathogenetic component of gastrointestinal bleeding.