Hypercoagulative syndrome
Contents:
Description:
The hypercoagulative syndrome is the coagulopathy which is characterized by clinical and laboratory signs of the increased blood coagulation in the absence of thromboses.
System of a blood coagulation
Reasons of a hypercoagulative syndrome:
1. Hyperthrombocytosis and high hyperglobulia (staza)
2. Damages of an endothelium (an ulceration of atherosclerotic plaques, an infection — sepsis, pathology of cell-bound immune complexes, vasculites, operations, injuries, etc.)
3. Hematogenous thrombophilias (deficit of AT III; lupoid anticoagulant; hyper concentration of the VIII factor, Villebrand's factor, XIII factor; anomalies of system a protein With, a mutant V factor Leiden, a mutant prothrombin of G20210A, a mutation of a gene of MTGFR (metilentetragidrofolat-reductase); decrease in fibrinolitic activity; "sticky thrombocytes", etc.
4. Contact of blood with foreign surfaces;
5. Traumatization and rupture of integrity of a vascular wall;
6. Thrombocytopenic states (aplastic anemia, syndrome Moshkovits, etc.);
7. Malignant tumors (crayfish, sarcomas, acute promiyelotsitarny leukosis, etc.);
8. Stressful states;
9. The mixed and hardly classified (idiopathic) forms.
One patient can have several factors of a trombogenicity.
Symptoms of a hypercoagulative syndrome:
- a bystry blood coagulation "in a needle";
— a clot in a test tube friable — quickly dissolved;
— shortening of a blood clotting time according to Li-Whyte;
— AChTV — is shortened, however AChTV can be normal or even extended;
— increase in a prothrombin ratio;
— increase in aggregation of thrombocytes;
— it is always extended — the fibrinolysis "is exhausted" (in tests: XIIa-dependent fibrinolysis; lysis of an euglobulinovy clot);
— plasminogen is lowered
Changes of AChTV, prothrombin ratio, aggregation of thrombocytes can meet both at the same time, and separately
Under unfavorable conditions, such as blood loss, an injury, diuretic, operation, a hypercoagulative syndrome can pass into a hypercoagulative phase of the IDCS
Clinical picture of a hypercoagulative syndrome:
Can be absent completely;
Headaches, bystry fatigue can be noted weight in the head;
At capture of blood from a vein "blood is turned in a needle";
After vein venipunctures easily and quickly fail "" — are thrombosed.
Treatment of a hypercoagulative syndrome:
- Elimination of the reason
- Heparin constantly in/in,
- Antiagreganta,
- Anticoagulants of indirect action (Pelentanum, Syncumarum, warfarin),
- Plasma exchange.
