Hipertansif olgularda hemostatik parametreler ve hedef organ hasarı ile ilişkisi

Haemostatic parameters in hypertensive patients and relationship with target organ damage

N. Deniz ESİN,Aslan ÇELEBİ,Vildan ERCAN,Deniz KOÇ,ELMAS BİBERCİ KESKİN,İsmail EKİZOĞLU,Yüksel ALTUNTAŞ

Özet

Amaç: Hipertansif olgularda Hedef Organ Hasan (HOH) ile he¬mostatik parametreler arasındaki ilişkiyi araştırdık. Gereç ve Yöntem: Çalışmaya 55 hipertansif olgu ile 25 sağlıklı normotansif olgu alındı. Olgularda 8-10 saatlik açlık sonrası kanda hemostatik parametreler; fibrinojen, D-dimer, protrombin zamanı (PTZ), aktive edilmiş parsiyel tromhin zamanı (aPTT), tromhosit sayısı ve lipid parametreleri (total kolesterol, HDL-ko-lesterol, LDL-kolesterol ve trigliserid) bakıldı. HOH olarak hipertansif nefropati, hipertansif retinopati ve sol ventrikül hipertrofisi (SVH) değerlendirildi. Bulgular: Hipertansif olgularda kontrol grubuna gore HDL-kolesterol seviyeleri düşük (p<0.001), LDL-kolesterol (p<0.001) ve trigliserid (TG) seviyeleri (p<0.00l) yüksek saptandı. Hipertansif olgularda serum aPTT, fibrinojen ve D-dimer düzeyleri kontrol gruplara göre anlamlı olarak yüksek (p<0.00l) saptanırken, tromhosit sayısı ve PTZ açısından anlamlı farklılık sap¬tanmadı. Hipertansif olgularda fibrinojen ve D-dimer seviyeleri retinopati, nefropati ve SVH olan olgularda olmayanlara göre istatistiksel olarak anlamlı düzeyde yüksek bulunmuştur (p<0,05). Sonuçlar: Hipertansif olgularda. aPTT, fibrinojen ve D-dimer seviyelerinin yüksek bulunması hipertansiyonun hemostaz bozukluğuna sebep olduğunu göstermektedir. Yüksek fibrinojen ve D-dimer seviyeleri HTda HOH ile ilişkilidir

Abstract

Objectives: We investigated the relationship between target organ damage (TOD) and haemostatic parameters in hypertensive patients. Methods and Materials: Fifty-five hypertensive patients and 25 healthy subjects. Were enrolled in this study after 8-10 hours of fasting haemostatic parameters: fibrinogen, fibrin D-dimer, protrombin time (PT), partial thromboplastin time (PTl), platelets, and lipid parameters (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) have been studied in blood sample. To determine target organ damage, hypertensive nephropathy,hypertensive retinopathy and left ventricle hypertrophy were evaluated. Results: In hypertensive group HDL-cholesterol levels were lower (p<0.001) and LDL-cholesterol (p<0.001) and triglyceride levels (p<0.001) were higher than healty subjects. In hypertensive group, the levels of serum fibrinogen and D-dimer were higher (p<0.00l) than that of healty subjects. No significant differences have been found in terms of platelets and PT when hypertensive patients and control groups were compared. It has been found that there is significant relationship between haemostatic parameters and TOD in hypertensive patients (p<0.05). Serum fihrinogen and D-dimer levels were higher (p<0.001) in hypertensive patients with TOD. Conclusions: As fibrinogen and D-dimer levels were found higher in hypertensive patients than healty subjects, it is considered that hypertension is related with haemostatic disorders. High levels of fibrinogen and D-dimer are related with TOD.