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D-dimers in pregnancy. Influence Leiden mutation and anticoagulation therapy.
FELIXOVÁ, Veronika
In my work D-dimers in pregnancy, influence of Leiden mutation and anticoagulant therapy, I study the D-dimer concentration in pregnant women with Leiden mutation and the potential influence of anticoagulant therapy. In the first part I deal with theory. I describe here the process of fibrinolysis, including its activators and inhibitors that influence the process of fibrinolysis, and in which D-dimers are being created. . I deal with the division of thrombophilia, on the condition congenital, acquired and mixed. .Among congenital thrombophilic states belongs resistance to activated protein C, which in most cases is caused by mutation factor V Leiden. I describe here the emergence of this mutation, the occurrence and the risks with which this mutation is linked. The most discussed risk factor for me was pregnancy, which I mention in my work. Another part deals with anticoagulation therapy. In the methodical part I describe the quantitative determination of the D-dimer level by an immunoturbidimetric test in the Laboratory of Hematology of the Hospital České Budějovice. I split the whole process into a preanalytical, analytical, and postanalytical part. The principle of analysis is the addition of polystyrene particles covalently coated with monoclonal antibodies, where D-dimers are bound together with particles to clump and increase cloudiness. The haze intensity is measured by optical density and is directly proportional to the concentration of D-dimers. In the fourth part of my work I processed the data provided by the Hematology Outpatient Hospital of České Budějovice. These are the investigated levels of D-dimers in women with Leiden mutation and in women without the Leiden mutation. Leiden mutation is a thrombophilic condition with a negative personal history of thromboembolism. This mutation results in a breakdown of the coagulation system, which is manifested by frequent thrombotic complications. The risk of thromboembolism is higher in these patients than in the other population. In pregnancy, it is necessary to check with a hematologist. In the charts and tables I have attempted to confirm the aim of the work that D-dimers in pregnant women with Leiden mutation are higher than in pregnant women without the Leiden mutation. I have also looked at anticoagulant therapy that is recommended to patients to prevent and treat thromboembolic disease. The aim of the work that the level of D-dimers in pregnant women with the Leiden mutation is higher, compared to women without the Leiden mutation, was confirmed to me. The effect of anticoagulant therapy on the level of D-dimers is that pregnant women without anticoagulant therapy achieve higher levels of D-dimers than pregnant patients with anticoagulant therapy.
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Importance of trombophilic mutations in clinical genetic.
Vavrušková, Klára ; Kuklík, Miloslav (advisor) ; Černá, Marie (referee)
Trombophilia means an increased disposition to creation of trombs. Health complication incurred as a consequence of hypercoagulation can be very serious. When a trombophilic mutation is found at a patient, it brings necassity of thrombosis - control in risk situations (e.g. pregnancy, operation) for the rest of the patient's life. There were filed 300 people (206 women and 94 men) with trombophilic mutations into my study of clinical signification of trombophilic mutations. These people were examinated in years 2008 - 2010. Most of positive medical findings - 266 people, were recorded in the area of MTHFR (C677T i A1298C) mutations. There were less findings in the field of FV Leiden and FII prothrombin mutations. Multipath trombophilic mutations were found at 99 patients. I accordance with foreign literature, our results advert to clinical consequences of trombophilic mutations like: repeated spontanious aborts, cerebrovascular akcident (CA), ischaemic heart disease (IHD), thrombosis, flebothrombosis, pulmonary embolism, varicose veins, aseptic necrosis of hip bone, arterial sclerosis and aortic stenosis. Mutations MTHFR C677T and MTHFR A1298C we found mainly at patients with CA, IM and IHD. Leiden mutation was most often found at patients with thrombosis, flebothrombosis and pulmonary embolism. We...
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