ABSTRACT
La coagulopatía es el denominador común en la amplia gama de procesos hepático crónicos, efecto principal de la deficiencia de vitamina K. A pesar de la falta de evidencia que sostiene su eficacia, su administración representa una parte del manejo de muchos pacientes con coagulopatía. Por tanto, el objetivo primario de este estudio fue comparar los tiempos de coagulación tras la administración de vitamina K en pacientes con enfermedad hepática crónica y trastornos de coagulación. Se postularon como secundarios la caracterización del paciente hepatópata según grupo nosológico por edad y sexo, así como las diferencias existentes entre las pruebas de coagulación basales con respecto a cada grupo. 72 pacientes fueron reclutados en 4 grupos, grupo 1: hepatitis B inactiva (n=6), grupo 2: hepatitis B crónica-hepatitis C (n=14), grupo 3: cirrosis (n=35) y grupo 4: hepatocarcinoma (n=17), se administraron 3 dosis de vitamina K de 10 mg cada una a intervalos de 24 horas, se midieron tiempo de protrombina (TP), radio normalizado internacional (INR) y tiempo de tromboplastina parcial activado (TPT) basales y cada 24 horas después de cada dosis. Se logró establecer una diferencia estadísticamente significativa en la corrección del tiempo de protrombina (31.04±9.62 a 21.69±8.48 PË0.0001) así como del INR (2.81±1.013 a 1.92±0.81, PË0.0001), hubo diferencia en cuanto a grupo diagnóstico y edad de presentación, así como en cuanto a tiempos de coagulación basales según diagnóstico. Por tanto, se demostró la efectividad de la vitamina K en la corrección del TP e INR.(AU)
Coagulopathy is the common denominator in the wide range of chronic liver processes, the main effect of vitamin K deficiency. Despite the lack of evidence supporting its efficacy, its administration represents a part of the management of many patients with coagulopathy. Therefore, the primary objective of this study was to compare clotting times after vitamin K administration in patients with chronic liver disease and coagulation disorders. The characterization of the liver disease patient according to nosological group by age and sex, as well as the differences between the baseline coagulation tests with respect to each group, were postulated as secondary. 72 patients were recruited into 4 groups, group 1: inactive hepatitis B (n = 6), group 2: chronic hepatitis B-hepatitis C (n = 14), group 3: cirrhosis (n = 35) and group 4: hepatocarcinoma ( n = 17), 3 doses of vitamin K of 10 mg each were administered at 24-hour intervals, prothrombin time (TP), international normalized radius (INR) and baseline activated partial thromboplastin time (TPT) were measured and each 24 hours after each dose. It was possible to establish a statistically significant difference in the correction of prothrombin time (31.04 ± 9.62 to 21.69 ± 8.48 PË0.0001) as well as the INR (2.81 ± 1.013 to 1.92 ± 0.81, PË0.0001), there was a difference in terms of group Diagnosis and age of presentation, as well as baseline clotting times according to diagnosis. Therefore, the effectiveness of vitamin K in the correction of TP and INR was demonstrated
Subject(s)
Humans , Male , Adult , Middle Aged , Vitamin K/pharmacology , Blood Coagulation/drug effects , Liver Diseases/therapy , Prothrombin Time , Blood Coagulation Tests/statistics & numerical data , Hepatitis B, Chronic/drug therapyABSTRACT
Clinical assessment of the blood clotting mechanism is usually made by measuring the time necessary for a sample of plasma to clot. In this work a semi-automatic method for measuring coagulation time is evaluated. It employs ultrasound, at 2.7 MHz, for monitoring variations of the viscosity in a plasma sample undergoing coagulation. The evaluation is performed by comparing measurements obtained by two well-known methods, the manual tilt tube and the fibrometer, with those obtained using the ultrasonic method. A total of 330 plasma samples from individuals with normal and altered homeostatic process were analysed. The experimental protocol follows two standard tests: the prothrombin time (141 samples) and the activated partial thromboplastin time (189 samples). The agreement between the three different methods is estimated statistically and it is shown that all the three can be used interchangeably for clinical purposes.