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STUDY OF CHANGES IN BLOOD BIOCHEMICAL AND
COAGULOGRAM INDICATORS IN PATIENTS WITH CYTOPENIC
SYNDROME
Kurbonova Z.Ch.
Anvarov J.A.
Shodiyeva G.E.
Adilov A.A.
Sherkulov B.B.
Tashkent Medical Academy
https://doi.org/10.5281/zenodo.13906480
Significance.
Today in the world, HBV infection and HCV infection are
detected in 42% and 21% of patients with liver cirrhosis, and these diseases
remain one of the global problems for public health. The disease occurs in young
people who have more work ability, and in most cases the result ends with
disability. According to the results of research, the death rate from liver cirrhosis
and hepatocellular carcinoma, which are the main complications of chronic viral
hepatitis, is 3.5% of all diseases. It is estimated that cases of decompensated
liver cirrhosis will increase in the next 10 years due to the fact that viral
hepatitis leading to liver cirrhosis is not diagnosed early and additional causes
are not taken into account. Therefore, preventing the development of cirrhosis
of the liver and reducing the causes of death remains an urgent problem.
The purpose of the study.
Analysis of biochemical and coagulation
markers in patients with liver cirrhosis due to viral infections, who experience a
decrease in blood cells.
Research material and methods.
Scientific research work was
conducted in the clinical base of the Tashkent Medical Academy and the
Republican Specialized Scientific-Practical Medical Center of Epidemiology,
Microbiology and Infectious Diseases during 2023-2024. A total of 60 patients
with liver cirrhosis (B, C, D) of viral etiology were studied in the study. 45% of
the patients in the study group were women and 55% were men. When divide
the patients by age, 31.6% of patients aged 20 to 40, 35% of patients aged 41 to
55, 56 to 75 and patients under the age of 33.4%. The tactics of clinical and
laboratory examination, diagnosis and treatment of patients were carried out on
the basis of "Report on diagnosis and treatment of infectious diseases" and
Order 542 of the Ministry of Health of the Republic of Uzbekistan. When
laboratory tests were performed on patients, analyzes were taken from all
patients from the first day of arrival to the hospital. These analyzes were
checked in the hospital laboratory by conventional methods.
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Results.
As a result of the study, total bilirubin was increased in 96% of 60
patients, conjugated bilirubin was increased in 28% patients, and unconjugated
bilirubin was increased in 90% patients. A decrease in total protein was
observed in 63% patients. An elevated level of transaminases in the blood
indicates the destruction of hepatocytes. With cirrhosis, transaminases increase
slightly (1.5-5 times) compared to the changes detected in hepatitis, because the
process is not as active as in acute inflammation. Normalization of the amount of
transaminases in the blood can indicate the advanced stages of cirrhosis and a
decrease in the number of hepatocytes. Examinations show that ALT and AST
levels have increased in almost all of the 60 patients, and urea and creatinine
levels have also increased by 2-3 times. Glucose is high in 6 patients.
Coagulation tests are also crucial in liver cirrhosis. Prothrombin time, which
measures the time it takes for blood to clot, is a key indicator of the coagulation
system's health. Since all proteins involved in coagulation are synthesized within
hepatocytes, liver cell death leads to impaired blood clotting. For prognostic
purposes, it's often not the prothrombin time itself that's considered, but rather
the International Normalized Ratio (INR), which compares the patient's
prothrombin time to a reference range. Studies have shown that in over 50% of
patients with liver cirrhosis, the PT is elevated, while hematocrit, fibrinogen, and
activated partial thromboplastin time (aPTT) levels remain relatively
unchanged.
Conclusions.
Biochemical analysis revealed elevated levels of total bilirubin,
direct bilirubin, indirect bilirubin, total protein, ALT, AST, LDH, and occasionally,
glucose. Urea, creatinine, and albumin levels remained relatively unchanged.
Coagulation studies showed a decreased prothrombin time. Prothrombin time is
a test that measures how long it takes for blood to clot and is an indicator of the
coagulation system's health. Since all proteins involved in coagulation are
synthesized within hepatocytes, liver cell death leads to impaired blood clotting
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