Activated protein C retards recovery from coagulopathy in severe acute pancreatitis
| Autor: | Jari Petäjä, Esko Kemppainen, Heikki Repo, Pauli Puolakkainen, Ville Pettilä, Minna Tallgren, Leena Kylänpää, Harri Mustonen, Outi Lindström, Lea Kyhälä |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty medicine.drug_class Clinical Biochemistry Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Coagulopathy Humans Medicine Thromboplastin Antithrombin Proteins Prothrombin time medicine.diagnostic_test Interleukin-6 business.industry Antithrombin Anticoagulant Anticoagulants General Medicine Blood Coagulation Disorders Middle Aged medicine.disease 3. Good health 030104 developmental biology Pancreatitis 030220 oncology & carcinogenesis Acute Disease Immunology Prothrombin Time Acute pancreatitis Female Partial Thromboplastin Time business Protein C medicine.drug Partial thromboplastin time |
| Zdroj: | Scandinavian Journal of Clinical and Laboratory Investigation. 76:10-16 |
| ISSN: | 1502-7686 0036-5513 |
| Popis: | Activated protein C (APC), an endogenous anticoagulant, has antithrombotic, fibrinolytic and anti-inflammatory properties. We recently conducted a controlled study (APCAP, activated protein C in severe acute pancreatitis) of APC treatment of patients with severe acute pancreatitis (SAP). Here we studied the effect of APC on the pivotal coagulation parameters of the surviving patients in the APCAP study.The study consisted of 20 patients of whom 10 patients had received APC and 10 patients had received placebo. Coagulation parameters, physiological anticoagulants, thrombograms and circulating levels of IL-6 and CRP were determined on admission and at days 1, 3-4 and 6-7.During follow-up, the temporal levels of prothrombin time (PT) decreased and the temporal levels of thromboplastin time (TT) increased in placebo group (p0.001 for both), but not in APC group. The temporal levels of antithrombin (AT) increased less in APC group than in placebo group (p = 0.011). The shapes of the SAP patients' thrombograms were strongly deranged and were marginally affected by APC treatment.Coagulopathy in SAP, a complex phenomenon, is not alleviated by APC treatment. Rather, the patients receiving APC are heading toward normal homeostasis of coagulation slower than patients receiving placebo. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|