PATHOGENETIC MECHANISMS OF DISTURBANCE OF REPAIR ABILITY OF TISSUES UNDER WEARING CONDITIONS
DOI: 10.22138/2500-0918-2020-17-1-53-59
G.V. Porjadin, T.I. Vlasova, P.P. Zajcev, O.V. Markin, V.V. Shhapov, N.S. Shejranov, O.V. Revva, E.V. Arsent'eva
Russian National Research Pirogov Medical University, Moscow, Russian Federation;
National Research Ogarev Mordovia State University, Saransk, Russian Federation
Abstract. Aim. To study the severity of endogenous intoxication, oxidative processes in the early postoperative period of acute peritonitis and acute pancreatitis, to determine their role in the pathogenesis of disorders of the healing process of laparotomy tissue. Materials and methods of research. Clinical studies in patients with acute peritonitis (n=25) and acute destructive pancreatitis (n=20). Patients were operated. The nature and extent of surgical interventions was determined by pathology. Access in all cases was laparotomic. The comparison group — control — (n=15) consisted of patients who underwent surgical interventions in the absence of an aggravating factor. Indicators of healthy volunteers of both sexes (n=17) were the conditional physiological norm. In the early postoperative period (1, 2, 3 days after surgery), microcirculation of laparotomy wound tissues was studied (LAKK-02, LLC NPP LAZMA, Russia). Cytological examination of wound exudate, redoxometry (ionometer EV-74, Russia). In the blood plasma, diene conjugates, malonic dialdehyde, phospholipase A2 activity, superoxide dismutase, the number of medium-weight molecules, the total and effective concentration of albumin (AKL-01 «Probe») were determined. Results. In the early postoperative period, in the wound exudate of patients of the main groups, the number of neutrophilic leukocytes increases, with a predominance of degenerative forms, the regenerative-degenerative index is below control. In the tissues along the suture line, characteristic signs of microcirculation disturbance, a significant reduction in redox potential, were established. These local pathological changes in the repair process correlated with indicators of endogenous intoxication and peroxidation of membrane lipids, which were significantly higher in patients of the main groups. Conclusion. Changes in local homeostasis in regenerating tissues and, as a result, a decrease in the rate of healing of a laparotomy wound are associated with disorders of homeostasis at the organism level — endogenous intoxication, peroxidation of membrane lipids, phospholipase activity. The indicated pattern may be the basis for the development of vector therapy regimens, which allows correcting the pathological mechanisms leading to inhibition of the reparative process.
Keywords: inflammation, regeneration, microcirculation, lipid peroxidation
Received 10.12.2020
For citation:Porjadin G.V., Vlasova T.I., Zajcev P.P., Markin O.V., Shhapov V.V., Shejranov N.S., Revva O.V., Arsent'eva E.V. Pthogenetic mechanisms of disturbance of repair ability of tissues under wearing conditions. Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2020, Vol. 17, no. 1, pp. 53–59. DOI: 10.22138/2500-0918-2020-17-1-53-59 (In Russ)
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Authors
Gennadiy V. Poryadin
Clinical Pathophysiology of Russian National Research Pirogov Medical University
Dr. Sci. (Med.), Professor, Corresponding member of the Russian Academy of Sciences,
Honorary professor of the Department of Pathophysiology
1 st. Ostrovityanova Moscow 117997 Russian Federation
Tatyana I. Vlasova
Dr. Sci. (Med.), Associate professor, Professor of the Department of Normal and
Pathological Physiology
Pavel P. Zaytsev
Applicant for the Department of Faculty Surgery
Oleg V. Markin
Cand. Sci. (Med.), Associate professor of the Department of Faculty Surgery
Vyacheslav V. Shchapov
Assistant of the Department of Faculty Surgery
Nikita S. Sheyranov
Cand. Sci. (Med.), Assistant of the Department of Faculty Surgery
Oksana V. Revva
Applicant for the Department of Faculty Surgery
Ekaterina V. Arsent’eva
Cand. Sci. (Med.), Associate professor, Associate professor of the Department of Normal
and Pathological Physiology
National Research Ogarev Mordovia State University
68 st. Bolshevitskaya Saransk Russian Federation 430005
vlasova.tatyanka@mail.ru