The Dynamics of the Functional State of Platelets in Patients with Acute Pancreatitis
Background. Acute pancreatitis is the inflammation of the pancreas and the parapancreatic fat tissue. Like any inflammation, it is associated with changes of hemostasis, where platelets play an important role, as they are a component of blood clotting, and most enzymatic hemostasis reactions occur on the surface of platelets. The aim of this study was to investigate the changes in platelet morphology and functional state of patients with acute pancreatitis. Materials and methods. We have assessed 18 patients (8 females, 10 males), who had been admitted to Lviv regional clinical hospital because of moderate acute pancreatitis  between 2010 and 2015. In 10 cases, acute pancreatitis was caused by cholelithiasis and microlithiasis, in 4 patients — by the alcohol, while 4 patients presented with idiopathic pancreatitis. All patients were treated according to the generally accepted guidelines [1–3, 6, 7]. We utilized microscopy of platelets and assessed the changes in platelet shape following spontaneous platelet activation after the drawing of sample. The method is based upon Fromovik and Milton technique (1982). Results. Decreased count of intact platelets (71.4 ± 1.1; р < 0.05) and increased count of activated cells was noted on the third day of disease, indicating early activation of platelet phase of blood clotting. The total fraction of active platelets on the third day of disease was 23.8 % (N = 7.9–17.7 %). Increase of the count of intact platelets was observed only on the 10th day of the course of moderate acute pancreatitis. The total fraction of active platelets on that day was 15.6 %. Conclusions. Our data on the changes in shape of platelets following stimulation indicate that these parameters may be used in conditions associated with impaired hemostasis. Intravascular activation of platelets is caused by numerous factors, including changes in vascular wall, tissue damage, etc. Many clinical studies have shown that morphological changes of platelets are early indicators of platelet activation.
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