|Title of the article||
The detoxification and hemostasis corrective ability of the lungs in acute pancreatitis
Aleksey P. Vlasov, Doctor of medical sciences, professor head of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), E-mail: firstname.lastname@example.org
Background. In recent years, there has been a great interest in dysregulatory pathology, especially the defeat of various organs and systems in acute pancreatitis, in which the mortality rate remains at a high level, which is largely associated with the syndrome of a systemic inflammatory response. Certainly, lung damage is one of the predictors in the pathogenesis of the aggravation of acute pancreatitis and the development of fatal complications. The purpose of this research is to study the detoxification and hemostasis correcting ability of the lungs in the experiment and in the clinic for acute pancreatitis. Materials and methods. The research is based on experimental and clinical studies. The experiments were performed on adult mongrel dogs (n=15), which were modeled under anesthesia for pancreatic necrosis by injecting bile into the pancreatic parenchyma. In the control period, relaparotomy and thoracotomy, lung tissue biopsy, and blood sampling were performed. 30 patients with acute severe pancreatitis were examined (17 men (56,7%), 13 women (43,3 %), the age was 53,8 ± 5,32 years). Methods of investigation: assessment of the severity of endotoxicosis, coagulation and fibrinolytic parameters of arterial and venous blood. The state of the coagulation-lytic system and lipid metabolism were determined in the lung tissue. Results. In an experiment on a model of biliary pancreatic necrosis and in the clinic in patients with acute severe pancreatitis, a significant deterioration in the detoxification ability of the lungs and changes in their ability to modulate the coagulation state of the blood were found. The experiment proved that the transformation of the functional state of the lungs is based on significant modifications of the lipid metabolism and the coagulation-lytic system of the organ tissues, the triggers of which are excessive activation of phospholipase systems and oxidative stress. Conclusions. In acute pancreatitis, as the disease progresses, there is a significant deterioration in the detoxification ability of the lungs and changes in their ability to modulate the coagulation state of the blood, which is due to sharp changes in the modification of lipid metabolism and the coagulation-lytic system of organ tissues due to excessive activation of phospholipase systems and oxidative stress.
pancreatitis, endogenous intoxication, lungs, hemostasis, lipoperoxidation
1. Vlasov A.P., Anaskin S.G., Vlasova T.I., Rubtsov O.Yu. [et al.]. Systemic inflammatory response syndrome in pancreatic necrosis: trigger agents, organ damage. Khirurgiya. Zhurnal im. N. I. Pirogova = Journal named after N. I. Pirogov. 2021;(4):21–28. (In Russ.)
Дата обновления: 24.02.2022 13:32