Fábio Cardoso Luan; Izolete Aparecida Thomazini; Iracema Carvalho; Delane Mercedes Gonçalves Carreira; Valter José Cassinelli; Paulo Câmara Marques Pereira; Benedito Barraviera
ABSTRACT
Platelet function and plasma fibrinogen levels were evaluated in 14 patients, 10 males and 4females, aged 13-59years bitten by Bothrops genus snakes. There was a statistical difference (p < 0.05) among plasma fibrinogen levels evaluated 24 and 48 hours after envenomation. There was a tendency towards normalization after 48 hours of treatment. The low platelet number was clear in 24-48 hour evaluations with a tendency towards normalization after 48 hours of treatment (p<0.05). When platelet function was stimulated by collagen and epinephrine, it appeared to be within normal values. On the other hand, when it was stimulated by adenosine diphosphate (ADP), platelet function was hypoaggregated by a single micromol concentration until 48 hours after treatment. At a 3 micromol concentration, there were alterations only before specific treatment (p<0.05). Fibrinogen levels and fibrin degradation product (FDP) levels appeared to be altered in 83.33% of patients evaluated. The authors suggest that platelet hypoaggregation is related to decreased fibrinogen and increased FDP levels.
Keywords: Platelet function. Fibrinogen. FDP. Bothrops.
RESUMO
Foram avaliadas a função plaquetária e os níveis séricos de fibrinogênio em 14 doentes picados por serpentes do gênero Bothrops, sendo 10 do sexo masculino e 4 do sexo feminino, com idades compreendidas entre 13 e 59 anos. Houve diferença estatística (p < 0,05) entre os níveis séricos defibrinogênio avaliados 24 e 48 horas após o acidente. Houve tendência à normalização após 48 horas do tratamento. A plaquetopenia foi evidente nas avaliações de 24 e 48 horas. Houve tendência à nomalização no 8o dia após o tratamento (p<0,05). A função plaquetária, quando estimulada pelo colágeno e epinefrina, apresentou-se dentro da normalidade. Quando estimulada pelo ADP, foi hipoagregante na concentração de 1 micromolar até 48 horas após o tratamento. Na concentração de 3 micromolar houve alteração apenas antes do tratamento específico (p<0,05). Os níveis de produtos de degradação defibrina (PDF) mostraram-se alterados em 83,33 % dos pacientes avaliados. Os autores sugerem que a hipoagregação esteja relacionada com níveis baixos de fibrinogênio e elevados de PDF.
Palavras-chave: Função plaquetária. Fibrinogênio. Produtos de degradação defibrina. Bothrops.
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Adress to correspondence:
Dr. Benedito Barraviera.
CEVAP/FM/UNESP.
Caixa Postal 576
18618-000
Botucatu, SP, Brasil.
Recebido para publicação em 23/05/94.
Faculdade de Medicina de Botucatu e Centro de Estudos de Venenos e Animais Peçonhentos da Universidade Estadual Paulista, Botucatu, SP.
