Bokatyeva V. V.

THE COMPATTIVE ASSESSMENT OF HEMOSTASIS SYSTEM’S STATE IN CONDITIONS OF CARDIOEMBOLIC STROKE’S LAUDABLE AND MORTAL OUTCOMES

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About the author:	Bokatyeva V. V.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	Theacute ischemic stroke is still the one of leading reasons of death and persistent disability in the most part of counties. The cardioembolic strokes makes near 30% of all ischemic strokes. The brain vessels occlusion occurs because of free embolicirculation. The most part of these emboli have the cardiac origin. The main risk of emboli formation occurs in condition of normal heart rhythm restoration after the period of ineffective cardiac contractions (arrhythmia). In conditions of ischemic stroke development the system of hemostasis is situated in conditions of significant hypercoagulation. In some cases this hypercoagulation can reach of excessive levels even up to disseminated intravascular coagulation. However some indexes of hemostasis system have the high lability because of permanent utilization an dalsothe replacement of cells and factors deficit by means of release of cells and factors from the depots and its synthesis. The aim of research is comparative assessment of hemostasis system’s state in conditions of cardioembolic stroke’s laud ableand mortal outcomes. The subject and methods of research. The 126 cardioembolic stroke patients took partin the study. 86 patients (45 maleand 41 female) had the laudable outcome of the disease. 40 patients (18 male and 22 female) had the mortal outcome. The analysis of indexes which characterized common and neurological state was performed. The hemostasis system’s indexes were also assessed. The volume and severity of central nervous system injury was estimated using the scales and indexes. The physical state was assessed after the results of laboratory and instrumental methods. The social and domestic adaptation was estimated using Rankine scale and Barthel Index. The hemostasis system’s state estimation was performed using the measurement of thrombocytes level, prothrombin ratio, fibrinogen and fibrin monomer complexes concentration. The results and discussion.The two clusters were separated out in male and female patients groups by means of sharp clustering using the algorithm of k-averages. The clusters differed one from another by the patients’ state severity, clinical, social and domestic outcome quality. The male and female patients with worse outcome of cardioembolic stroke were referred to the second cluster. The research of connections between the examined indexes and its structure was performed using the factor analysis. This analysis has shown that the system of hemostasis of all patients goes in state of hypercoagulation. The indexes characterized the state of different hemostasis components were in stable enough. This can be explained as the common property of hemostasis system which consists in the balance between the synthesis and consumption of hemostasis factors. The configuration of connections between the hemostasis indexes in male group with mortal outcome had shown the stiff determination. It denoteson very high exertion of all hemostasis system’s components both cellular and plasmic. Such exertion can be debated as the signof hemostasis system’s complex disorder till the disseminated intravascular coagulation development. The comparison of died male and female patients factor structures allows to make a conclusion that connections in hemostasis system of male patients have more stressed character than in female patients system. It can be explained by the differences in age structure of cardiovascular diseases in male and female populations. The disorders of hemostasis is important part of such pathology development.
Tags	hemostasis system’s state, cardioembolic stroke, factor analysis
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Publication of the article	«World of Medicine and Biology» №2(50) 2 part 2015 year, 007-013 pages, index UDK 616.12-008.313-053.9