Scientific journal
European Journal of Natural History
ISSN 2073-4972

EVALUATION OF THROMBOCYTE CAPACITY AS METHOD OF EARLY DIAGNOSTICS OF HEMORRHAGIC SYNDROME AT CRIMEAN-CONGO HEMORRHAGIC FEVER

Lazareva Ye.N., Samotruyeva M.A.
Nowadays in the Southern regions of Russia, as well as in Astrakhan Region, a steady incidence rate of Crimean-Congo hemorrhagic fever (CCHF) is marked (Maleyev V.V., Sannikova I.V., 2005); up to 9% of fatal cases of the disease being registered (Maleyev V.V., 2003), the root of which is in deep hemocoagulation disorders. According to the modern data, the initiating role in the pathogenesis of hemorrhagic syndrome and thrombotic complications at many infectious processes is played by thrombocytes (Polyakova A.M., 2000).

With the purpose of carrying out a modern and appropriate pharmacological correction of hemostasis disorders at CCHF there appeared a necessity to define the capacity of blood platelets during the acute period of the disease. To solve the specified problem clinical-laboratory trial of 20 patients was carried out on the basis of Astrakhan State Medical Academy and Regional Clinical Infectious Hospital, Astrakhan, from May till August, 2005. The patients´ average age was 56,6±4,16 years old. The disease proceeded in the form of average severity (62%) and severe (38%) forms. The diagnosis was made on the foundation of a complex of anamnestic, epidemiological, clinical-laboratory data and was serologically verified in the IFA reaction to the CCHF virus antigen with the antibody titer of 1:800 -1:1600. Counting of platelets in the venous blood and the analysis of their aggregative ability were carried out on the analyzer NFP BIOLA (model 230LA). The platelet capacity was evaluated in aggregation value (V %) and speed (S %). ADP in the concentration of 2,5 mcMol was chosen as an inductor.

In 70% of the patients clinical implications of hemorrhagic syndrome in the form of intensive hemorrhagic rash on skin integuments and gingival bleeding were marked. In peripheral blood platelet number decreased up to 71,2±5,9х109/l, and in venous one - up to 48,5±4,6х109/l; it being 17,7х10х9/l in single cases.

The research results showed that the aggregation value (V%) was strongly decreased as compared to the control values (4,02 ± 0,7 и 24,3±1,4 при р<0,0001), and the time (Tv) during which platelet activity reached its maximum reduced to 1΄25″±0,6 from the regular one of 4΄01˝±0,5. The aggregation speed (S) was authentically decreased twofold from the control values (7,2±0,5 and 4,3±1,3 accordingly, р<0,0001), and the time (Ts) of reaching its maximum - decreased (20˝±1,8 against 12˝±0,4, р< 0,05). The aggregates were of small radius (3,5±0,23), while in  donors it was equal to 6,5±0,7. The discharge reaction of own agonists in the platelet granules was not registered on all the occasions, that gave evidence of the release failure or their absence.

Thus, considerable disorders of hemostasis thrombocyte link in CCHF patients were found out in the result of the research.  Perhaps, it is a leading cause of the hemorrhagic syndrome development. That is why, when admitting patients to the hospital, it is necessary to define the platelet capacity for carrying out the appropriate pathogenetic therapy.


The article is admitted to the III International congress "Practising doctor", Russia (Sochi), April, 10-12th, 2007, came to the editorial office on 03.03.07