Primer osteoartrit olgularında plazma ve sinovyal sıvı doku faktörü ve koagülasyon parametrelerinin incelenmesi

Ozet Amac. Dejeneratif eklem hastaliklarinda sinovyadaki fibrin birikimi hastaligin prognozunu agirlastiran sebepler arasindadir. Bu calismada total diz artroplastisi (TDA) ameliyatina girecek olan hasta grubunun sinovya ve kanlarindaki doku faktoru (DF) ve diger koagulasyon faktorlerinin degisimlerinin incelenmesi amaclandi. Yontem. Bu calismada kontrol grubuna kiyasla (n=20), hasta grubunun (n=20) sinovya ve plazmalarinda DF miktari ve ilgili olan diger ekstrensek koagulasyon faktorleri incelendi. Plazma ve sinovyanin DF duzeyleri ELISA yontemi ile, diger koagulasyon faktorleri ve protrombin zamani ticari kitlerle, fibrinojen otomatik koagulometrede ve C-reaktif protein nefelometrik yontemle olculdu. Bulgular. Hasta grubunun DF seviyeleri hem sinovyada, hem de plazmada anlamli olarak yukselmistir (p<0,001 ve p<0,05). Bununla birlikte diger ekstrensek sistem faktorleri de olgularin sinovyalarinda kontrol grubuna gore artmistir. Sonuclar. TDA ameliyatina girecek olan olgularin sinovya ve plazmalarinda artmis DF’ den kaynaklandigini dusundugumuz yuksek fibrin miktari hasta grubunda koagulasyon ve enflamasyonu tetikleyebileceginden hastalik surecini olumsuz yonde etkileyebilir. Bu calismada gozlemlenen DF ve diger bazi ekstrensek sistem faktorlerinin plazmada ve ozellikle sinovyadaki artislari koagulasyonu aktif hale getirerek bu hasta grubundaki tromboz riskini arttirdigini dusunmekteyiz. Anahtar sozcukler: Doku faktoru, enflamasyon, koagulasyon Abstract Aim. Since in degenerative joint diseases accumulation of fibrin is one of the reasons for intensifying the disease’ prognosis. In this study we aimed to investigate the changes of tissue factor (TF) and other coagulation parameters in cases who will have an operation of total knee arthroplasty surgery. Methots. In our current work, control group (n=20) and patient group (n=20) were examined in comparison according to the TF and other extrinsic coagulation factors. TF levels of plasma and synovia were determined by ELISA method whereas other coagulation factors and protrombin time are evaluated with commercial kits, fibrinogen is determined by automatic coagulometer and C-reactive protein nephelometric method. Results. TF levels of the patient group increased significantly both in synovia and plasma (p<0.001 and p<0.05). Besides, other extrinsic system factors increased in cases’ synovia in relation to the control group. Conclusion. The high amount of fibrin, which we believe is related to increased TF in synovia and plasma, may trigger coagulation and inflammation in the patient group and may negatively affect the disease process. TF increase, which was observed in this study, may accompany rises in synovia and activate coagulation which in return may result in thrombosis risk in the patient group. Keywords: Tissue factor, inflammation, coagulation