Терапевтический архив (Mar 2014)
Mechanisms of comorbidity in hemophilia patients
Abstract
AIM: To study the somatic status of patients with varying degrees of hemophilia, the mechanisms of comorbidity from the results of studies of systemic microcirculation (MC), body composition, and key metabolic parameters/MATERIAL AND METHODS: One hundred and twenty hemophilia patients were examined. The authors studied their viscera; MC by laser Doppler flowmetry; body composition parameters by bioelectrical impedance; and blood cholesterol, albumin, and iron levels/RESULTS: The incidence of chronic diseases of the kidney, digestive system, and myocardium (from electrocardiographic findings), and liver was found to be proportional to the severity of hemophilia. The number of diseases per patient with mild, moderate, or severe hemophilia was 1.0±0.02, 1.5±0.02, and 2.5±0.03, respectively. Four and two systems were ascertained to be commonly affected in patients with severe and mild hemophilia, respectively. The investigators studied the comorbidity mechanisms that included changed systemic MC; a decreased perfusion associated with excess fat mass; evolving iron-deficiency; anemia; protein and mineral deficiencies; and a tendency to lower blood cholesterol levels, which reflected energoplastic wastes in hemophilia patients/CONCLUSION: The detection of comorbidity and mechanisms of its development in hemophilia makes it possible to improve the prevention of hemorrhage and visceral pathology in these patients and their quality of life.
