Avaliação da agregação plaquetária e do fibrinogênio em pacientes com doença arterial obstrutiva crônica dos membros inferiores

Abstract

The work has as objective investigates the platelet activity, measured by the test of the platelet aggregation, and the plasmatic levels of fibrinogen in the different apprenticeships of the disease obstructive arterial chronic of the lower limbs. An individual study, observacional, traverse and analytical, was accomplished where the platelet aggregation test and the fibrinogen dosage was dosed through the collection of the blood veined in the upper and lower limbs, accomplished in the enfirmaries of Medical Clinic, Surgical Clinic and in consulting-room of Vascular Surgery of the Fundação Santa Casa de Misericóridia do Pará, in the city of Belém. The patients were divided in 2 groups, besides the group control: Group A - 08 patient male or feminine with age between 50 and 70 years bearers of disease obstructive arterial chronicle of the lower limbs in the phases evolutionary of claudication intermittent, pain in rest and/or lesion trophryc; Group B - 10 patient male or feminine with age between 50 and 70 years bearers of risk factors for disease obstructive arterial chronicle of the lower limbs, Group C - 10 patient male and/or feminine of the group it controls with age between 50 and 70 years. The exclusion criteria were the regular use of medicines platelet antiagraggates, vasexpanders, haemorhelogic drugs, bearers of evil neoplasias and hepaticpathology. In the statistical study, the program was used Bioestat. As results observed that in this work statistical meaning was not observed between the hiperaggregation states or hipoaggregation plaquetária in the studied groups. Among the sick patients, 75% presented high levels of fibrinogen, not having statistical difference among the variation of the fibrinogen in the upper member in relation to the lower member. In the patients of the group B (risk factors), 22% possessed high fibrinogen, and all were smokers for a long time and 10% of the group control presented high fibrinogen. Among the diabetic patients, 88,9% presented high levels of fibrinogen in the leg, when compared to the non diabetics (p = 0,002). It is relevant to tell that the fibrinogen was elevated in patient bearers of Obstructive Arterial Disease Outlying (PAOD), if compared to the group controls and risk factor. The prevalence of high levels of fibrinogen was larger in the group A (sick) when compared with the groups control and risk factor (p= 0,003). As conclusion of this study, it was allowed to infer that the fibrinogen can be used as a factor of independent risk for complications thrombotic in patients with PAOD. Contradicting what it is observed in the literature, it was verified in the patients group with PAOD a state of platelet hipoaggregation, where there would be an association of platelet hipoaggregation and development of vascular events, what could be related with the ischaemia degree presented by the patients, because in this study 75% of the same ones they were in ischaemia phase with pain in rest or with trophyc lesions of the lower member, characterizing serious level of ischaemia. However, new studies need to be accomplished for us to corroborate these observations.