Ukr.Biochem.J. 2025; Volume 97, Issue 6, Nov-Dec, pp. 105-112

doi: https://doi.org/10.15407/ubj97.06.105

The state of the hemostasis system in patients with sensoneurological hearing damage caused by acoustic injuries in combat zone

16.12.2025   Uncategorized

T. A. Shydlovska1, N. M. Voroshylova1, Yu. B. Burlaka1,
D. S. Korolova2, Yu. D. Vinnichuk2*, D. M. Kuleshova1,
V. O. Kotov1, S. V. Verevka1

1SI “Prof. O.S. Kolomiichenko Institute of Otolaryngology
of the National Academy of Medical Sciences of Ukraine”, Kyiv;
2Palladin Institrute of Biochemistry, National Academy of Sciences of Ukraine, Kyiv;
*e-mail: vinnichukju@gmail.com

Received: 03 June 2025; Revised: 17 September 2025;
Accepted: 28 November 2025; Available on-line:     2025

The problem of early diagnosis and treatment of acute traumatic injury and its complications has been sharply actualized in today’s circumstances of combat actions. Аcubarotrauma (ABT) is a specific dama­ge characterized by manifestations from the side of the auditory system and those not related directly to the structures of the auditory system, such as severe forms of sensorineural deafness (SND). The development of SND can be associated with vascular pathology, hydrodynamic impact on blood vessels, damage to the vascular endothelium and uncontrolled release of various clotting factors into the bloodstream. The purpose of this work was to estimate the state of the hemostasis system in patients who received ABT injuries in combat zone and have sensorineural hearing disorders. The following parameters in the patient’s blood plasma were measured: fibrinogen concentration, activated partial thromboplastin time (APTT), prothrombin time (PT), functionally inactive forms of prothrombin (FIFP), ecamulin time, the levels of protein C (PC), soluble fibrin-monomer complexes (SFMCs), soluble fibrin (SF) and D-dimer. The control group was formed by 15 healthy persons with normal hearing. 94 patients with combat ABT injuries were divided into 4 groups according to the severity of hearing impairment and the period after getting ABT: 1, 2 – patients with a mild hearing impairment, who contacted a medical facility within 2 months or more than 2 months after the injury respectively; 3, 4 – patients with a more severe hearing impairment who contacted a medical facility within 2 months or more than 2 months after the injury, respectively. Patients of all groups had significantly prolonged APT and increased SF, SFMCs and prethrombin-1 levels in the blood plasma compared to the control parameters. In patients of the 4th group, a PT prolongation was noted. The protein C level in the 1st, 2nd, and 3rd groups showed a tendency to decrease and was statistically reduced compared to the control in the 4th group. Concentration of D-dimer decreased in patients of the 1st and 2nd groups, remained at the control level in the 3rd, and increased in the 4th group. The fibrinogen level and ecamulin time ET in all studied groups remained at the level of control values. The observed dysfunctions of the hemostasis system links in patients with combat ABT indicate a slow development of disseminated intravascular coagulation syndrome. That is why patients with a severe hearing impairment due to combat ABT, regardless of the period of seeking medical help, need examinations after the injury according to a special algorithm of laboratory signs.

Keywords: , , ,

References:

  1. Shydlovska TA, Shydlovska TV, Petruk LG, Shevtsova TV, Gvozdeckiy VА. Quantitative characteristics of data of subjective audiometry in military personnel who received acoustic trauma in real combat conditions with typical shape of audiometrics curve with different degrees of hearing function decrease. Otorhinolaringology. 2023;6(3): 38-47. (In Ukrainian). CrossRef
  2. Shydlovska TA, Shydlovska TV, Kozak MS, Ovsyanyk KV, Petruk LG. The peculiarities of hemodynamic violations for patients with combat acoustic trauma and violations in the central departments of auditory analyzer in the dynamics of treatment. Otorhinolaryngology. 2022; 5(5): 2-9. (In Ukrainian). CrossRef
  3. Shydlovska TA, Burlaka YuB., Voroshylova NM, Petruk LH, Verevka SV. Peculiarities of the hemostasis system in acoustic injuries received as a result of combat operations. Otorhinolarynhology. 2022; 3–4(5): 2–10. (In Ukrainian).
  4. Chernyshenko V, Shteinberg K, Lugovska N, Ryzhykova M, Platonova T, Korolova D, Lugovskoy E. Preparation of highly-concentrated autologous platelet-rich plasma for biomedical use. Ukr Bioсhem J. 2019;91(2):19-27. CrossRef
  5. Korolova DS, Stohnii YM, Gryshchuk VI, Zhuk SI, Us IV, Chernyshenko TM, Kostiuchenko OP, Klymenko KP, Platonov OM, Ivashchenko OI, Chernyshenko VO. Thromboelastographic study of fibrin clot and molecular basis of maximum clot firmness. Ukr Biochem J. 2021;93(2):62-70. CrossRef
  6. Platonova TN, Zaichko NV, Chernyshenko TM, Gornitskaya OV, Gryshchuk VI. Assessment of the informativeness and prognostic significance of traditional screening and additional laboratory tests for the diagnosis of thrombophilia. Lab Diahnost. 2010;4(54):3-10. (In Russian).
  7. Kozynets GP, Tsyhankov VP, Korolova DS, Gornytska OV, Savchuk OM, Chernyshenko VO, Chernyshenko TM, Platonova TM. The Rise of Factor X Level in Blood Plasma of Patients at Severe Burn Injuries. J Burn Care Res. 2022;43(4):965-970. PubMed, CrossRef
  8. Lugovskoi EV, Kolesnikova IN, Komisarenko SV. Usage of monoclonal antibodies for determination of localization of antigenic determinants and fibrin polymerization sites within fibrinogen and fibrin molecules and their application in test-systems for diagnostics and the threat of thrombus formation. Biotechnol Acta. 2013;6(4):33-42. CrossRef
  9. Korolova DS, Hornytska OV, Lavrik AS, Druzhyna NM, Prysyazhna N, Platonova TM. Characterization of the blood coagulation system in morbidly obese patients. Ukr Biochem J. 2023;95(4):3-9. CrossRef
  10. Al-Achi A. The Student’s t-Test: A Brief Description. Res Rev J Hospital Clin Pharm. 2019;5(1):1-3.
  11. Moore GW. Thrombophilia Screening: Not So Straightforward. Semin Thromb Hemost. 2024;50(8):1131-1152. PubMed, CrossRef
  12. Asmis L, Hellstern P. Thrombophilia Testing – a Systematic Review. Clin Lab. 2023;69(4). PubMed, CrossRef
  13. Singh R, Gautam P, Sharma C, Osmolovskiy A. Fibrin and Fibrinolytic Enzyme Cascade in Thrombosis: Unravelling the Role. Life (Basel). 2023;13(11):2196. PubMed, PubMedCentral, CrossRef
  14. He S, Wallèn H, Bark N, Blombäck M. In vitro studies using a global hemostasis assay to examine the anticoagulation effects in plasma by the direct thrombin inhibitors: dabigatran and argatroban. J Thromb Thrombolysis. 2013;35(2):131-139. PubMed, CrossRef
  15. Kumar SS, Sabu A. Fibrinolytic Enzymes for Thrombolytic Therapy. Adv Exp Med Biol. 2019;1148:345-381. PubMed, CrossRef
  16. Zermatten MG, Fraga M, Moradpour D, Bertaggia Calderara D, Aliotta A, Stirnimann G, De Gottardi A, Alberio L. Hemostatic Alterations in Patients With Cirrhosis: From Primary Hemostasis to Fibrinolysis. Hepatology. 2020;71(6):2135-2148. PubMed, CrossRef
  17. Storozhuk LO, Platonova TM, Storozhuk BG, Seleznyova IB, Storozhuk ОB, Dovgalyuk TV. Evaluation of pro- andanticoagulant factors of hemostasis and parameters of coagulation potential during the development of comorbid conditions in patients with CKD VD stage. Methodical recommendations. Vinnytsia, 2019. 42 p. (In Ukrainian).
  18. Korolova D, Chernyshenko V, Platonova T, Chernyshenko T, Lugovskoy E. Detection of prethrombin 1 in human blood plasma. Int Blood Res Rev. 2016;5(2):1-7. CrossRef
  19. Korolova DS, Platonova TM, Gornytska OV, Chernyshenko V, Korchynskyi O, Komisarenko SV. Diagnostic Value of Protein C Depletion in Pathologies Associated with the Activation of the Blood Coagulation System. Int J Mol Sci. 2025;26(13):6122. PubMed, PubMedCentral, CrossRef
  20. Udovenko A, Makogonenko Y, Korolova D, Druzhyna N, Chernyshenko V, Komisarenko S. Formation and elimination of soluble fibrin and D-dimer in the bloodstream. Croat Med J. 2023;64(6):421-429. PubMed, PubMedCentral, CrossRef
  21. Nikulnikov PI, Liksunov OV, Ratushnyuk AV, Lugovskoy EV, Kolesnikova IM, Lytvynova LM, Kostyuchenko OP, Chernyshenko TM, Gornytska OV, Platonova TM. Estimation of state of the blood coagulation system after the operation for abdominal aorta aneurysm. Klin Khir. 2012;(9): 32-36. (In Ukrainian).
  22. Franchini M, Focosi D, Pezzo MP, Mannucci PM. How we manage a high D-dimer. Haematologica. 2024;109(4):1035-1045. PubMed, PubMedCentral, CrossRef
  23. Tayal D, Jain P, Goswami B. D-dimer – a multifaceted molecule. Horm Mol Biol Clin Investig. 2024;45(2):75-84. PubMed, CrossRef
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