Бюллетень сибирской медицины (Dec 2014)

CLINICAL STATUS AND CHEMILUMINESCENT ACTIVITY OF NEUTROPHILS IN PATIENTS WITH ADVANCED PURULENT PERITONITIS IN THE DYNAMICS OF POSTOPERATIVE PERIOD

  • A. A. Savchenko,
  • D. V. Cherdantsev,
  • O. V. Pervova,
  • I. I. Gvozdev,
  • A. G. Borisov,
  • V. A. Shapkina

DOI
https://doi.org/10.20538/1682-0363-2014-6-10-19
Journal volume & issue
Vol. 13, no. 6
pp. 10 – 19

Abstract

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The aim of this study was to evaluate the clinical condition and to study the chemiluminescent activity of granulocytes of patients with widespread purulent peritonitis in the dynamics of post-operative treatment. The severity of the patients was determined by the SAPS scale, the presence of systemic inflammatory response syndrome was assessed by the criteria of the ACCP/SCCM. Severity and prognosis of the disease was evaluated using the Mannheim peritonitis index and the index of abdominal cavity. The severity of multiple organ failure at admission to the hospital and in postoperative period dynamics were determined by the scale of the SOFA. The study of lucigenin- and luminal-dependent chemiluminescence of neutrophils in peritonitis were taken on admission to the hospital, and on the 7th, 14th and 24th day of the postoperative period. There were a variety of systemic complications (tertiary peritonitis, perforation of hollow organs, abscesses of the abdominal cavity and other) in patients with widespread purulent peritonitis 2nd severity in 96,2% of cases. The mortality rate among patients amounted to 22.2%. It was found in the study of neutrophils chemiluminescent activity that intensity of the “respiratory burst” in pre- and postoperative periods in patients with peritonitis is defined mainly by the synthesis level of secondary reactive oxygen species. The level of synthesis of superoxide radicals by neutrophils in a state of relative dormancy, increased by 14 days after the operation and is reduced to the reference level to the 21st day. In the preoperative period and before the end of the observation level of synthesis of secondary reactive oxygen species by neutrophils of patients with peritonitis was increased, but is on the background of the slow activation of enzymes, providing a “respiratory burst”. Trend towards normalization of neutrophils chemiluminescent activity in the blood of patients with peritonitis by the end of the observation period (24th day of the postoperative period).

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