Динаміка показників оксидантно-антиоксидантних реакцій у післяопераційному періоді у хворих на поширений перитоніт

Abstract

Purpose - to determine the effect of the developed treatment of patients with peritonitis on the dynamics of indicators of oxidant-antioxidant reactions and to justify the need for the use of the proposed drugs in the complex treatment of peritonitis. Matherials and methods. The study included 124 patients with toxic and terminal stages of peritonitis, who were divided into 3 groups: the Group I included 39 patients in whose complex treatment we included cytochrome C; the Group II included 41 patients whose complex treatment included cytochrome C and a solution containing levocarnitine and arginine hydrochloride; the Comparison group included 44 patients in whom the specified drugs were not used. The content of diene conjugates, reactive oxygen species (ROS), S-nitrosothiols, superoxide dismutase (SOD), carbonyl groups, and sodium nitrite was determined in the patients. Statistical processing of the study results was performed using the Statistical software EZR v. 1.64. Results. In patients of the Group I and the Group II, the use of the proposed treatment contributed to the optimization of oxidant-antioxidant reactions: a decrease in the production of diene conjugates, ROS, S-nitrosothiols, carbonyl groups, sodium nitrite during the study, optimization of SOD production, especially in the Group II. In patients of the Comparison group, decompensation in oxidant-antioxidant reactions was determined, associated with a significant increase in the production of diene conjugates, ROS, S-nitrosothiols and a decrease in SOD during the entire period. These trends developed against the background of an increase in the content of nitric oxide products and the activation of processes associated with the oxidative modification of blood plasma proteins. Conclusions. The use of cytochrome C and a solution containing levocarnitine and arginine hydrochloride in the complex treatment of patients with disseminated peritonitis helps to optimize oxidant-antioxidant reactions, which leads to a decrease in the manifestations of inflammation. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.