Perinatal Asfiksinin Hemostaz Üzerine Etkileri

Amaç: Perinatal asfiksi, hayatın ilk haftasında morbidite ve mortaliteyi artıran en önemlinedenidir. Bu çalışmada asfiktik bebeklerin dissemine intravasküler koagulasyona eğilimiaraştırıldı.Materyal ve Metod: İzmir Dr. Behçet Uz Çocuk Hastanesi’ne başvuran çeşitli derecelerdeasfiksiye maruz kalmış 30 ve kontrol grubu olarak da herhangi bir problemi olmayan 20yenidoğan bebek alındı. Venöz kanda Protein C, Protein S, Antitrombin III, Protrombin zamanı(PT), Parsiyel tromboplastin zamanı(PTT), Trombin time, Trombosit sayısı, Fibrinojen, D-Dimerdeğerlerine bakıldı. Hasta grubu asfiksi derecelerine göre sınıflandırıldı ve guruplar arasıkarşılaştırma yapıldı.Bulgular: Doğumu izleyen erken dönemde asfiktik bebeklerin Antitrombin(AT) III(31,35±12,14), Protein C (30,45±15,39) ve Protein S (39,76±21,01) düzeyleri kontrol grubunagöre düşük bulundu. PT (21,68±15,49 sn)ve PTT (63,40±28,38 sn) asfiktik grupta kontrolgrubuna göre yüksek bulundu. Asfiksi derecesi arttıkça fibrinojen (200,31±82,14 mg/dl)düzeylerinin düştüğü görüldü. Asfiktik grupta D-dimer (495,26±555,49 ng/ml) yüksekliğigösteren bebeklerin oranı kontrol grubuna göre yüksekti. Trombosit sayısı asfiktik grupta kontrolgrubuna göre düşük idi ve asfiksi derecesi arttıkça daha belirgin bir düşüş gösterdi. Asfiktikgrubun kendi içinde asfiksi derecesine göre yapılan değerlendirmede Ürik asit ve SGPTdüzeylerinin asfiksi derecesi ile doğru orantılı olarak yüksek olduğu bulundu.Sonuç: Asfiktik bebeklerde Protein C, Protein S, AT III, Fibrinojen düzeyleri ve trombositsayıları belirgin olarak düşük, PT, PTT, INR ve D dimer düzeyleri ise yüksektir

Anahtar Kelimeler:

Asfiksi, yenidoğan, hemostaz

The Effects of Perinatal Asphyxia on Hemostasis

Aim: Perinatal asphyxia is the most important reason that increases morbidity and mortality inthe first week of the life. In this work the tendency of Asphyctic babies on disseminatedintravascular coagulation was investigated.Material and method: Of those who applied to Dr. Behçet Uz Pediatrics Hospital, 30 newbornbabies who had been subjected to different degrees of asphyxia and 20 ones having no problemsas control group were taken. Protein C, protein S, antithrombin III, prothrombin time (PT),partial thromboplastin time (PTT), thrombin time, thrombocyte number, fibrinogen, D-Dimervalues in venous blood were investigated.The patient group was classified in terms of asphyxiadegrees and comparison was made between the groups.Results: In the early period following the birth, antithrombin (AT) III (31,35 12,14), ProteinC(30,45±12,14), Protein C (30,45±15,39) and Protein S (39,76±21,01) levels were found lowin comparison to the control group. PT (21,68±15,49 sec) and PTT (63,40±28,38 sec) inasphyctic group were found high in comparison to the control group. It was seen that as asphyxiadegree grew fibrinogen (200,31±82,14 mg/dl) levels decreased. The rates of the babiesdemonstrating D-dimer (495,26±555,49 ng/ml) height in asphyctic group were high incomparison to the control group. The thrombocyte number (206100±100073) in asphyctic groupwas low and as asphyxia degree grew it decreased more remarkably. In the evaluation doneaccording to the degree of asphyxia within the asphyxia group itself uric acid and SPGT levelswere found high in a directly proportionate way to the degree of asphyxia.Conclusion: Protein C, Protein S, AT III, fibrinojen levels and trombosit numbers are lowoutstandingly in asphyctyc babies. But, PT, PTT, INR and D dimer levels are high

Keywords:

Asphyxia, newborn, hemostasis,

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