The influence of the level of products of oxidal modification of proteins and enzymes of antioxidant protection on the process of post-operation hypoparathyroidism

Abstract

Aim. To improve the results of treatment and prophylaxis of postoperative hypoparathyroidism by considering pathogenetic universal mechanisms of cell damage and processes of protection of the cells vital functions on the basis of the analysis of operated patients with pathology of the thyroid gland, as well as to prove the necessity of the prescription of preparations with antihypoxant-antioxidant action in the postoperative period. Material and Methods. The research is based on the results of a comprehensive examination and treatment of 70 patients with different thyroid gland pathology who were inpatients at the Surgery Department of the Ivano-Frankivsk Central City Clinical Hospital and at the Ivano-Frankivsk Precarpathian Cancer Dispensary from 2014 to 2017. Among the examined patients there were 46 women (65.7%) and 24 men (34.3%). Hemithyroidectomy was performed in 26 out of 70 patients (37.1%), in 16 out of 70 patients (22.9%) - subtotal resection of thyroid gland lobe; in 14 out of 70 patients (20.0%) - thyroidectomy; in 14 out of 70 patients (20.0%) - thyroidectomy with central and peripheral lymph node dissection. Determining of the products of oxidative modification of proteins in blood serum was performed by reaction of proteins with 2.4-dinitrophenylhydrosine. The optical density was recorded using a spectrophotometer SF-16. Determination of catalase was performed using the method of A. Bakh and S. Zubkova. The statistical processing of the obtained results was performed using the standard program package "Statistica 6.0 for Windows" (StatSoft, USA). Results and Discussion. As a result of the study it was determined that an imbalance of systems of active forms of oxygen - antioxidant protection occurred in all patients in the postoperative period, but the pathological process was significantly deepened in patients with signs of hypoparathyroidism after surgery. Disturbance of the balance of peroxidation systems of lipid-oxidative modification of proteins on the one hand and antioxidant defense systems on the other hand were detected from the first day after the operation and were increased during the 3rd day, and in the absence of correction, they were significant during the 7th day of the postoperative period. A promising direction of complex therapy in patients with signs of postoperative hypoparathyroidism was the use of medicines with antioxidant effect. Therefore, in the postoperative period in patients operated for thyroid diseases, an increase in the products of the oxidative modification of proteins and lipid peroxidation, along with the reduction of catalase enzymes, superoxide dismutase, ceruloplasmin, was observed. Conclusions. In the postoperative period in patients operated on for thyroid gland diseases, the increase of oxide modification of proteins (OMP) products against the background of reduction of enzymes of antioxidant defense (AOD) could be traced. It was determined that imbalance of OMP-AOD system deepened in patients with presence of signs of hypoparathyroidism. It was determined that the maximum increase in OMP products occurred in patients within the 1st day of post-operative period, while the maximum decrease in AOD enzymes was observed in patients during the 6th-7th days, indicating an important role of oxidative stress in the pathogenesis of post-operative hypoparathyroidism. The use of drugs with antioxidant-antihypoxant action, namely the drug Citoflavin in the early postoperative period is a promising area of complex therapy for patients with signs of postoperative hypoparathyroidism.

Keywords

• hypoparathyroidism, oxide modification of proteins, catalase, superoxide dismutase