Avtor/Urednik		Pakiž, Maja
Naslov		Občutljivost trombembolov iz pljučne arterije na zunajtelesno trombolizo
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2006
Obseg		str. 31
Jezik		slo
Abstrakt		Massive pulmonary embolism (MPE) is clinically seen as obstructive shock or hypothension without shock. Mortality is very high, up to 40%. Using transesophageal echocardiography (TEE) we can directly see thrombemboli in pulmonary artery or in iYs main divisions. Two types of central pulmonary thromboemboli (TE) can be detected by TEE: type A - hypoechoic highly mobile TE and type B - hyperechoic immobile TE. It has been previously shown that on hospital admission morphology of the TE is independent predictor of 30-day mortality in patients with MPE. The aim of our study was to explore above mentioned assumption. Thus, we investigated whether ultrasound morphology could predict ex-vivo lysibility of central pulmonary arteries TE, which were collected during autopsies. Ultrasound morphology of 45 central pulmonary artery TE was determined. Success of thrombolysis was measured by loss of weight of TE and by concentration of D-dimer. After one hour incubation with rt-PA the weight of TE was reduced more in group A (16 ± 2%) compared to Group B (11 ± 2%), p<0,001, and the contentration of D-dimer was higher in group A (408 ± 79 micro g/L) compare to group B (302 ± 78 micro g/L), p<0,01. Grey scale mean negatively correlated with percentage of TE weight reduction. D-dimer concentration positively correlated with grey scale mean of TE. Ultrasound morphology of TE form central pulmonary arteries correlates significantly with ex-vivo lysibility. Hypoechoic TE are more susceptible to thrombolysis compared to hyperechoic TE. The results of our research will be important for new research and changes in treatment of patients with MPE.
Deskriptorji		PULMONARY EMBOLISM PULMONARY ARTERY FIBRINOLYSIS CLOT RETRACTION ALTEPLASE DIMERIZATION