Author/Editor		Božič, Mojca
Title		Laboratorijski vidiki venske tromboze: dejavniki tveganja, prepoznavanje in spremljanje zdravljenja
Translated title		Laboratory aspects of venous thrombosis: risk factors, identification and therapy monitoring
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2003
Volume		str. 109
Language		slo
Abstract		Mildly elevated levels of plasma homocysteine (hyperhomocysteinemia) increase in general population the risk of deep-vein thrombosis (DVT) for about three-fold. We found on average for 10 % higher levels of total piasma homocysteine in patients with pregnancy related DVT than in healthy women. Plasma homocysteine was not associated with methylenetetrahydrofolate reductase polymorphism C677T. 1Vlechanisms, which lead to the atherogenic and thrombotic complications of hyperhomocysteinemia, are not well understood. However, homocysteine has a detrimental effect on endothelium. The aim of our study was to assess the influence of hyperhomocysteinemia on tissue plasminogen activator and tissue plasminogen activator inhibitor - two fibrinolytic proteins released by endothelium. Although a correlation between homocysteine and both fibrinolytic proteins was observed, no difference in .these two proteins was found in patients with DVT with or without hyperhomocysteinemia. High fibrinogen is also a risk factor for DVT. In the recent years several polymorphisms in fibrinogen genes were found, that could influence fibrinogen levels in plasma. We tried to assess the role of fibrinogen polymorphisms Taq I, Hae III and Bcl I on the development of DVT. We found similar frequencies of the polymorphisms in patients with DVT and healthy subjects. An association between polymorphisms and plasma fibrinogen was observed only in healthy subjects. The hypothesis of causal role of fibrinogen in DVT aetiology was rejected. Clinical signs of DVT are unspecific therefore, in patients with suspected DVT expensive and time-consuming objective testing is needed. Low levels of D-dimer, a degradation product of cross-linked fibrin, can reliably exclude DVT. In our study, Ddimer rrieasured with ELISA method showed the best diagnostic accuracy (100 sensitivity and 78% specificity). (Abstract truncated at 2000 characters)
Descriptors		THROMBOSIS VEINS HOMOCYSTEINE POLYMORPHISM (GENETICS) ALTEPLASE PLASMINOGEN ACTIVATOR INHIBITOR 1 FIBRINOGEN PROTHROMBIN DIMERIZATION METHYLENETETRAHYDROFOLATE DEHYDROGENASE HEPARIN ENZYME-LINKED IMMUNOSORBENT ASSAY