Interrelation between the system markers of hemostasis and hemocoagulation disorders in patients with tuberculosis in respira-tory organs and comorbid diabetes mellitus after surgical interven-tion on respiratory organs

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The relevance of the work is determined by the necessity to study the markers of the coagulation system of blood and hemocoagulation disorders in patients with pulmonary tuberculosis and comorbid diabetes mellitus in different stages of the postoperative period.

Aim. This study was conducted to identify the interrelation between the system markers of hemostasis and the signs of intravascular blood coagulation development in patients with pulmonary tuberculosis and comorbid diabetes mellitus (TB-DM) in terms of the volume of surgical intervention on respiratory organs.

Materials and Methods. The extent of changes in the system markers of hemostasis was determined in 89 patients with TB-DM before and after surgical treatment. The following parameters of the blood coagulation system were measured: concentration of fibrinogen, level of soluble fibrin–monomer complexes, compensatory potential of fibrinolysis level, activities of the fibrinolytic and anticoagulation systems (antithrombin III). The parameters of prothrombin activity were also studied. The operation material of the lungs was prepared for morphological examination.

Results. The parameters of the hypercoagulation syndrome increased in all the study groups from days 3 to 5 and reached the maximum on days 7 to 10 and 14 to 17 of the postoperative period. The compensatory activation of the fibrin-stabilizing factor and the fibrinolytic system was also observed. The most prominent changes in the hemostasis markers were found in the group of patients after lobectomy. Microthrombotic lesions of the vessels of pulmonary microcirculation with a partial or complete obturation of the lumen were morphologically visualized.

Conclusion. Hypercoagulation syndrome with intravascular blood coagulation was observed in this category of patients. This finding indicated that thromboembolic complications require timely prevention and treatment. This study may be used as a basis for developing measures that can prevent hemocoagulation complications in patients with TB-DM after surgical treatments.

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About the authors

Georgy V. Chitorelidze

Central Research Institute of Tuberculosis

Author for correspondence.
ORCID iD: 0000-0001-5062-9788
SPIN-code: 4301-7364

PhD-Student of the Surgery Department

Russian Federation, Moscow

Bella A. Serebryanaya

Central Research Institute of Tuberculosis

ORCID iD: 0000-0001-9168-0336
SPIN-code: 4918-4812

PhD in Biological Sciences, Leading Researcher of the Pathomorphology, Cell Biology and Biochemistry Department

Russian Federation, Moscow

Larisa N. Lepekha

Central Research Institute of Tuberculosis

ORCID iD: 0000-0002-6894-2411
SPIN-code: 6228-8382
ResearcherId: B-1165-2019

MD, PhD, Professor of the Pathomorphology, Cell Biology and Biochemistry Department

Russian Federation, Moscow

Aleksandr V. Papkov

Ryazan State Medical University

ORCID iD: 0000-0003-2988-990X
SPIN-code: 4902-5864
ResearcherId: L-4679-2018

MD, PhD, Professor of the Department of Phthisiology with a Course of Radiation Diagnosis

Russian Federation, 9, Vysokovoltnaja, Ryazan, 390026

Mamad-Bagir A. Bagirov

Central Research Institute of Tuberculosis

ORCID iD: 0000-0001-9788-1024
SPIN-code: 8820-5448

MD, PhD, Professor of the Department of Surgery

Russian Federation, Moscow


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Supplementary files

Supplementary Files
1. Fig. 1. Blood vessels with edematous endothelium, infiltration of the walls with cell elements of inflammation, thrombosis. Staining with hematoxylin and eosine. Magnification х280

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2. Fig. 2. Thrombosis of a middle-diameter blood vessel with formation of perivascular zone of infarction. Staining by van Gieson. Magnification х320

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