| Authors |
Vlasov Aleksey Petrovich, Doctor of medical sciences, professor, head of sub-department of faculty surgery with courses of topographic anatomy and operative surgery, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), vap.61@yandex.ru
Vlasova Tat'yana Ivanovna, Doctor of medical sciences, associate professor, sub-department of normal and morbid physiology with a course of hygiene, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), v.t.i@bk.ru
Muratova Tat'yana Aleksandrovna, Candidate of medical sciences, associate professor, sub-department of faculty surgery with courses of topographic anatomy and operative surgery, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), tam-0811@mail.ru
Al'-Kubaysi Sheykh Akhmed Saad, Postgraduate student, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), shekhahmed88@yandex.ru
Bolotskikh Viktor Aleksandrovich, Candidate of medical sciences, associate professor, sub-department of operative surgery with topographic anatomy, Voronezh State Medical named after N. N. Burdenko (10 Studencheskaya street, Voronezh, Russia), bolotskich@mail.ru
Kirdyashkina Ol'ga Viktorovna, Senior lecturer, sub-department of biochemistry, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), tam-0811@mail.ru
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| Abstract |
Background. The purpose of the work is to experimentally and clinically study dynamic changes of markers of endogenous intoxication, blood coagulation, lipid metabolism in blood plasma at acute pancreatitis, as well as to define their connection with the disease severity.
Materials and methods. The experimental part of the study included tests on 34 adult dogs. It resulted in creation of a model of acute pancreatitis of different severity. The clinical part of the work included 62 patients with mild acute pancreatitis (edema) (n = 32) and severe (pancreatic necrosis) forms (n = 30), who underwent
standardized complex therapy according to the national clinical recommendations. During the check period the researchers examined the blood plasma, particularly, the markers of endogenous intoxication, the plasma hemostasis system indicators, the content of lipid peroxidation products, the activity phospholipase A2 and superoxide dismutase. For statistical data processing the authors used methods of medical statistics.
Results. It has been established experimentally that acute pancreatitis features increased markers of endogenous intoxication, coagulation capacity of blood plasma and lipid peroxidation. There is a correlation of indices of endogenous intoxication and disorders of the hemostatic system and lipid destabilization. The intensity of these pathological changes is determined by the severity of the pathology. The clinical data shows a similar trend in the studied parameters of patients with acute pancreatitis of different severity and confirms the ability to use hemostasis, lipid peroxidation, endogenous intoxication as the markers of severity of acute pancreatitis.
Conclusions. The systems markers of severity of acute pancreatitis at the aseptic phase are hemostasis, lipid peroxidation, endogenous intoxication. On the one hand, these markers influence each other and are defined with severity of the disease, on the other – they determine bases components of the pathogenesis of acute pancreatitis. It is shown that one of the central pathogenetic links of the desease appears to be lipid destabilizations, which are involved in determination of the state of the hemostatic system and severity of endogenous intoxication. One of the central "targets" of the impact of these destabilization is microcirculation vessels. The manifestations of structural and functional disorders, observed in it, lead to even greater disorders of the microcirculation, which closes a vicious cycle, creating favorable conditions for complications.
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