[Dynamics of parameters of systemic inflammation and hemocoagulation in early postoperative period in patients with heart valve prostheses].

In 42 patients with rheumatic heart defects before implantation of mechanical valves and on days 5 and 20 after surgery we measured parameters of hemostasis, levels of proinflammatory cytokines (interleukin 6 [IL-6], tumor necrosis factor- [TNF-] and C-reactive protein [CRP]) as well as activity of enzymes (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase and its MB fraction). On day 5 after surgery we revealed substantial elevation of IL-6, TNF-, and CRP levels, increase of activity of the studied enzymes, contents of fibrinogen and soluble fibrin monomer complexes (SFMC), and to the contrary lowering of antithrombin III level and decrease of number of platelets. On day 20 IL-6 and TNF- levels remained significantly elevated compared to preoperative values. Concentrations of enzymes and parameters of hemostasis returned to baseline values while content of SFMC remained significantly decreased. In early postoperative period levels of IL-6 and TNF- significantly correlated with that of SFMC and platelet count what reflected interrelation ship of processes of inflammation and coagulation. Severity of systemic inflammatory reaction in patients with implanted prosthetic valves influenced optimal doses of warfarin.