RESUMO
AIM: Comparative evaluation of systemic concentration of some cytokines in various forms of SIR in patients with acute calculous cholecystitis. MATERIAL AND METHODS: The study included 32 patients with acute calculous cholecystitis and SIR. According to ASSR/SCCM criteria SIR 2 was in 11, SIR 3 - in 8, SIR 4 - in 7 patients, 6 patients had sepsis. Serum TNF-α, IL-6, IL-4 and IL-10 were determined prior to surgery, in 3 and 7 days postoperatively by using of ELISA. RESULTS: There was a cytokine imbalance whose severity depended on SIR severity and presence of sepsis. CONCLUSION: Surgical intervention on background of basis therapy does not correct cytokine imbalance. So adequate pharmacological correction is required.
Assuntos
Colecistite Aguda , Colecistolitíase/complicações , Interleucinas/sangue , Síndrome de Resposta Inflamatória Sistêmica , Fator de Necrose Tumoral alfa/sangue , Azerbaijão , Colecistite Aguda/complicações , Colecistite Aguda/imunologia , Colecistite Aguda/cirurgia , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória/métodos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Síndrome de Resposta Inflamatória Sistêmica/classificação , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Síndrome de Resposta Inflamatória Sistêmica/imunologiaRESUMO
The article analyzed the results of surgical treatment of 137 patients with obstructive jaundice of benign genesis. An immune status was studied in serum in dynamics before surgery. The rates of CD3, CD4, CD8, CD19, Ig A, M, G were determined on the first, third, seventh and fourteenth days after operation. The levels of TNFα, IFNγ, IL-2, IL-6, IL-4, IL-10 were investigated in serum and at the same time TNFα, IL-4, IL-6 were noted in the bile duct and IL-6 - in urine. Obstructive jaundice of cholelithiÑ genesis is characterized by disbalance of immune and cytokine status. The depth of disbalance depends on the degree of hepatic dysfunction and presence of purulent cholangitis. The directed cytokine therapy by ronkoleykin influenced positively on elimination of disbalance in immune and cytokine status and this therapy improved results of surgery in postoperative period.