Author/Editor		Jarc, Maja; Zemljič, Eva
Title		Vpliv dolgotrajnega antikoagulacijskega zdravljenja na fibrinolitično aktivnost krvi pri bolnikih z vensko trombozo
Translated title		Blood fibrinolytic activity during anticoagulant treatment in patients with deep vein thrombosis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. 3
Publication year		2000
Volume		str. 239-53
Language		slo
Abstract		Ninety-nine consecutive patients (42 M, 57 W) with objectively confirmed deep vein thrombosis (DVT) were included. They were 60 +- 10 years old. Fourty-seven were older than 65 years. In 41 patients DVT was idiopathic. In 20 patients advanced malignancy was present. In other patients DVT developed after surgery or immobilization. In acute DVT patients were treated five to seven days with standard heparin combined with warfarin after one to three days of heparin treatment. The prothrombin time, fibrinogen, D-dimer and euglobulin clot lysis time (ECLT) were determined on the first and the seventh day of treatment and three and six months after the acute DVT: For the same anticoagulant effect patients older than 65 years needed a lower doses of warfarin than younger patients. During a long-termtreatament with warfarin 47% of the INR in patients without malignancy and only 25% of INR in patients with malignancy were in the therapeutic range (INR 2.0-3.0). Three months after acute DVT significant prolongation of ECLT was observed. The concentration of D-dimers and fibrinogen decreased in the first three months. Six months after the acute DVT the results were similar to those obtained after three months. During the warfarin tretament we observed prolongation of ECLT and values were back to normal after finishing the warfarin therapy. Therefore, we assume that a long-term warfarin treatment influenced blood fibrinolytic activity.
Summary		V raziskavo smo vključili 99 zaporednih bolnikov (42 moških, 57 žensk) z objektivno potrjeno vensko trombozo (VT). Stari so bili 60 +- 10 let. Starejših od 65 let je bilo 47 bohiikov Primarno VT je imelo 41 bolnikov. Sekundarna VT je bila pri 20 bolnikih posledica malignoma. V akutnem obdobju VT smo bolnike 5-7 dni zdravili s standardnim heparinom, prvi do tretji dan smo uvedli varfarin. Prvi in sedmi dan zdravljenja ter tretji in šesti mesec po akutnem dogodku smo določili protrombinski čas, izražen z IXNR (angl. International Normalised Ratio), fibrinogen, D-dimere in čas evglobulinske lize (ČEL). Starejši bolniki so za enak antikoagulacijski učinek potrebovali manjše odmerke kumarinov. Med dolgotrajnirn antikoagulacijskim zdravljenjem z varfarinom je bilo 47 % INR v terapevtskem območju (INR 2,0-3,0), prižbcolnikih z malignom pa samo 25 % INR. Tri mesece po akutni VT smo opazovali podaljšanje ČEL, D-dimeri so padli, prav tako je v proem tromesečju padla koncentracija fibrinogena. Rezultati po šestih mesecih so bili podobni. Med zdravljenjem z varfarinom smo izmerili podaljšanje ČEL, ki se je po ukinitvi zdravljenja z varfarinom vrnil v normalno območje, iz česar sklepamo, da dolgotrajno zdravljenje s kumarini vpliva na fibrinolitično aktivnost krvi.
Descriptors		THROMBOPHLEBITIS ANTICOAGULANTS BLOOD COAGULATION TESTS MIDDLE AGE AGED NEOPLASMS IMMOBILIZATION HEPARIN WARFARIN PROTHROMBIN TIME FIBRINOGEN TREATMENT OUTCOME