Сучасні медичні технології (Mar 2022)
Results of protease inhibitor instructions in patients in acute burning disease
Abstract
The purpose of the study was to determine the clinical efficiency of proteinase inhibitor usage in patients with burns. Materials and Methods. The results of studies performed in 32 patients with superficial and deep burns were analyzed: 12 patients of the main group, whom were used the proteinase inhibitor drug in the complex treatment, and 20 comparison groups, who were treated according to the standard scheme. The content of calpains, α-1 proteinase inhibitor (α-1-IP), α-2 macroglobulin (α-2-MG) and tumor necrosis factor α (TNF-α) in patients’ peripheral blood were determined. Results. The decrease in proteolytic activity of blood in patients of the main group was determined as a decrease in calpain levels by 1.16 times (50.51 ± 10.32 μEq/min on the 10th-16th day compared to baseline 58.83 ± 3.62 μEq/min on the 1-4th day after injury), while in the comparison group indicators of calpain content did not tend to decrease. Comparing the TNF-α values of the main group and the comparison group, it was found that the values of the main group were significantly lower 1.15 times on the 5th-9th day (245.33 ± 10.36 pg/ml and 281.2 ± 13, 67 pg/ml) and 1.08 times lower on the 10th-16th day (236.60 ± 8.78 pg/ml and 256.35 ± 15.70 pg/ml). The usage of ulinastatin led to a less pronounced decreasing in proteinase inhibitors levels: α-1-IP (79.31 ± 1.54 μmol/l of the main group compared with 72.1 ± 7.8 μmol/l of the control group on the 5th-9th day after injury and 75.34 ± 5.13 μmol/l of the main group compared with 68.0 ± 4.9 μmol/l of the control group on the 10-16th day after injury), α-2-MG (2.63 ± 0.24 g/l of the main group compared with 2.2 ± 0.4 g/l of the control group on the 10-16th day after injury). Conclusion. The results of the study indicate that the proteinase inhibitor drug included in the standard treatment regimen for acute burns optimizes the proteolytic activity of peripheral blood, promotes the inflammatory response optimal development, inhibits the endothelial dysfunction development.
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