Doğan Halef Okan, Büyüktuna Seyit Ali, Kapancik Sercan, Bakir Sevtap
Department of Biochemistry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Arch Virol. 2018 Mar;163(3):609-616. doi: 10.1007/s00705-017-3653-1. Epub 2017 Nov 20.
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic viral disease. The aim of this study was to evaluate the association between inflammation, coagulation and endothelial dysfunction in CCHF. The study population consisted of 40 patients and 50 healthy controls. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), endocan, high sensitive C-reactive protein (hsCRP), international normalized ratio (INR), prothrombin time (PT), activated partial thromboplastin time (aPTT) and platelets values were determined in blood samples. Median hsCRP (p < 0.0001), ALT (p < 0.001), AST (p < 0.001) and aPTT (p < 0.001) values were found to be higher in CCHF patients than in the healthy control subjects. In contrast, median endocan (p = 0.0006) and platelet (p < 0.001) concentrations were found to be lower in CCHF patients than in healthy controls. Serum hsCRP concentrations positively correlated with PT, aPTT and INR in CCHF patients, whereas serum endocan levels were not correlated with hsCRP, PT, aPTT and INR. In conclusion, endothelial dysfunction is one of the key steps in CCHF disease development and serum endocan may be used as a biomarker to evaluate endothelial dysfunction in patients. There is no relationship between increased inflammation and endothelial dysfunction. Coagulation abnormalities might be related to the impaired hepatic synthetic function of coagulation factors. Increased hsCRP concentrations may have a compensatory role in restoring impaired hemostasis in CCHF. Further research is needed to confirm these findings and to examine possible explanations.
克里米亚-刚果出血热（CCHF）是一种由蜱传播的人畜共患病毒性疾病。本研究的目的是评估CCHF中炎症、凝血和内皮功能障碍之间的关联。研究人群包括40例患者和50名健康对照。测定血样中的丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、内脂素、高敏C反应蛋白（hsCRP）、国际标准化比值（INR）、凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）和血小板值。发现CCHF患者的hsCRP中位数（p<0.0001）、ALT（p<0.001）、AST（p<0.001）和aPTT（p<0.001）值高于健康对照者。相反，发现CCHF患者的内脂素中位数（p=0.0006）和血小板（p<0.001）浓度低于健康对照者。CCHF患者血清hsCRP浓度与PT、aPTT和INR呈正相关，而血清内脂素水平与hsCRP、PT、aPTT和INR无相关性。总之，内皮功能障碍是CCHF疾病发展的关键步骤之一，血清内脂素可作为评估患者内皮功能障碍的生物标志物。炎症增加与内皮功能障碍之间没有关系。凝血异常可能与凝血因子肝脏合成功能受损有关。hsCRP浓度升高可能在恢复CCHF受损止血方面具有代偿作用。需要进一步研究来证实这些发现并探讨可能的解释。
