Povezanost stresa i aktivacije koagulacijskog sustava

master's thesis

• Title (english): Relationship between stress and activation of the coagulation system
• Author: Marta Kmet
• Mentor: Nada Vrkić (mentor)
• Committee member: Nada Vrkić (predsjednik povjerenstva)
• Committee member: Marija Grdić Rajković (član povjerenstva)
• Committee member: Sandra Šupraha Goreta (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2017-06-08, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

Dvadesetčetirisatna dežurstva predstavljaju jedan od većih stresora za liječnike jer osim
umora i poremećaja cirkadijarnog ritma uključuju odgovornost u donošenju odluka i rad s
pacijentima koji nisu uvijek suradljivi. Poznato je da stres na radnom mjestu dovodi do aktivacije
koagulacijskog sustava, a nastalo hiperkoagulabilno stanje pogoduje razvoju kardiovaskularnih
oštećenja.
Cilj ovog rada bio je ispitati utjecaj dvadesetčetirisatnog dežurstva na globalne
koagulacijske pretrage: PV, APTV i TV te na koncentraciju fibrinogena i vrijeme fibrinolize. U
istraživanju je sudjelovalo 29 liječnika na specijalističkom usavršavanju. Liječnicima je krv uzeta
tri puta: prije, tijekom i nakon dežurstva. Rezultati su pokazali da nije došlo do značajne aktivacije
koagulacijskog sustava koja bi se odrazila na globalne pretrage i koncentraciju fibrinogena.
Međutim, pokazalo se da je vrijeme fibrinolize dobiveno euglobulinskim testom produženo u dva
jutarnja mjerenja u odnosu na mijerenje tijekom dežurstva u večernjim satima. Nije jasno u kojoj
je mjeri navedena promjena uzrokovana stresnim dežurstvom, a u kojoj fiziološkim oscilacijama u
aktivaciji fibrinolize.

Abstract (english)

24-h work shifts are known to be one of the major stressors for physicians because of the
circadian rhythm disruption and tiredness. Besides that, they include responsibility in making
decisions and working with patients who are not always cooperative. Studies have shown that
work stress leads to the activation of the coagulation system, and that the resulting
hypercoagulable state favors the development of cardiovascular damage.
The aim of this study was to examine the effects of a 24-h work shift on global coagulation
parameters: prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin
time (TT), but also the fibrinogen concentration and fibrinolysis time. The study group included 29
physicians on education. The blood was sampled three times: before, during and after the work
shift. Our results have shown that there was no coagulation system activation that would affect
global tests and fibrinogen concentration. However, fibrinolysis time obtained with the euglobulin
test was extended in two morning measurements compared to the evening measurement. It is not
clear if this is caused by work stress or the physiologic oscillations in fibrinolysis.

• Keywords: stres; hiperkoagulabilnost; fibrinoliza; koagulacijske pretrage
• Keywords (english): stress; hypercoagulability; fibrinolysis; coagulation tests
• Language: croatian
• URN:NBN: urn:nbn:hr:163:909046
• Study programme: Title: Medical biochemistry; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-11-16 12:12:17