ASSESSMENT OF THE FUNCTIONAL STATE OF THE ENDOTHELIUM IN PATIENTS WITH VIRAL HEPATITIS BEFORE TOOTH EXTRACTION

Abstract Tooth extraction is the most common operation, after which hemorrhagic complications often occur, especially in patients with chronic viral liver disease. This condition is caused by damage to the endothelial lining of blood vessels. Based on this, the purpose of this study was to study the features of endothelial dysfunction before tooth extraction in patients with viral hepatitis. 58 patients with hepatitis В and C with different prescription periods of the disease were examined. In patients with viral hepatitis, an increase in platelet aggregation activity on the effect of an ADP inducer (Tma) by 45% was noted before tooth extraction. The lengthening of the activated recalcification time (AVR) by 37% observed by us in patients with viral hepatitis reflects a deficiency of plasma factors (XII, XI, XIII ) of the blood coagulation system and indicates a state of hypocoagulation. Against this background, high values of alpha-2 macroglobulin in the blood (4 times) and Willebrand factor (15%) and a significant decrease (by 35%) in the content of protein C in the blood of the examined patients were noted. The obtained results of the study indicate that these patients have a narrow band of maintaining hemostatic balance, and the existing balance can easily be transformed into hypo- or hypercoagulation, which requires preventive measures to prevent complications after tooth extraction.