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.
Assuntos
Colangite , Cálculos Biliares/complicações , Insuficiência Hepática , Interleucina-2/administração & dosagem , Icterícia Obstrutiva , Adjuvantes Imunológicos/administração & dosagem , Adolescente , Adulto , Idoso de 80 Anos ou mais , Colangite/etiologia , Colangite/imunologia , Colangite/terapia , Colecistectomia/métodos , Feminino , Insuficiência Hepática/etiologia , Insuficiência Hepática/imunologia , Insuficiência Hepática/terapia , Humanos , Testes Imunológicos , Interleucina-4/análise , Interleucina-6/análise , Icterícia Obstrutiva/etiologia , Icterícia Obstrutiva/imunologia , Icterícia Obstrutiva/terapia , Testes de Função Hepática/métodos , Masculino , Período Perioperatório , Cuidados Pré-Operatórios/métodos , Proteínas Recombinantes , Resultado do Tratamento , Fator de Necrose Tumoral alfa/análiseRESUMO
The article analyzes the results of effect of combined and local cytokine- and ozone therapy on the indices of lipid peroxidation, endogenous intoxication and ferroproteins in 111 patients with diffuse peritonitis. It was shown, that combined sequential local and systemic cytokine and ozone therapy allows correcting the expression of endogenous intoxication and lipid peroxidation in diffuse peritonitis. This method suppresses an inflammation in the abdominal cavity. At the same time, it accelerates the elimination of intestine atony and thereby potentiates the possibilities of traditional methods of treatment.
Assuntos
Adjuvantes Imunológicos/administração & dosagem , Citocinas/administração & dosagem , Endotoxemia/tratamento farmacológico , Laparotomia , Ozônio/administração & dosagem , Lavagem Peritoneal/métodos , Peritonite/terapia , Complicações Pós-Operatórias , Drenagem , Vias de Administração de Medicamentos , Monitoramento de Medicamentos , Quimioterapia Combinada , Endotoxemia/etiologia , Endotoxemia/metabolismo , Ferritinas/metabolismo , Humanos , Lactoferrina/metabolismo , Laparotomia/efeitos adversos , Laparotomia/métodos , Peroxidação de Lipídeos/efeitos dos fármacos , Oxidantes Fotoquímicos/administração & dosagem , Peristaltismo/efeitos dos fármacos , Peritonite/etiologia , Peritonite/metabolismo , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/prevenção & controle , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
The author analyzed the results of surgical treatment of 60 patients with generalized peritonitis (GP). The level of interleukin-6 in blood, serum, urine and peritoneal exudates were followed up and the diagnostic significance of interleukin was comparatively studied. All patients were treated by conventional intensive postoperative therapy, without immune correction. The severity of GP was determined by Mannheim peritoneal index (MPI): 17 patients had MPI, 20 patients had MPI II-23 and MPI III. The study revealed that the degree of the changes of IL-6 in blood, urine and peritoneal exudates depended on the severity of patients according to MPI. An analysis of the data suggests that the comparative study of IL-6 in peritoneal exudates, blood, urine during the postoperative period in patients with GP is one of the objective criteria for the assessment of the immune system. Increasing the rates of peritoneal exudates in the postoperative period shows a continuation of the systemic inflammatory response.
