Abstract
The influence of traditional therapy supplemented with polyoxidonium on the state of cellular immunity and the cytokine status of blood of patients with pararectal fistulas was studied. It was established that the development of pararectal fistula is accompanied by forming a marked imbalance in the subpopulations of lymphocytes and cytokines. Analysis of the efficacy of the treatment regimen in patients with chronic paraproctitis in terms of the number of indicators different from the normal level showed that the administration of polyoxidonium in addition to the standard treatment regimen allowed to normalize 11.5% of the indicators, 27.0% of the parameters, while 34.5% had no change after the treatment. Thus, the administration of polyoxidonium in addition to the standard therapy, despite having the correction of a number of the immunometabolic parameters, does not permit to normalize the disturbed parameters of immunity in patients with pararectal fistulas indicating an insufficient immunotropic (immunocorrecting) component of the used immunorehabilitation scheme in this category of patients.
Highlights
Lazarenko V.A.1, Zaikin E.Y.1, Kalutsky P.V.2, Kalutsky A.P.1 1 Department of Surgical Diseases of FPE, 2 Department of Microbiology, Virology, Immunology of Kursk State Medical University, Kursk The influence of traditional therapy supplemented with polyoxidonium on the state of cellular immunity and the cytokine status of blood of patients with pararectal fistulas was studied
It was established that the development of pararectal fistula is accompanied by forming a marked imbalance in the subpopulations of lymphocytes and cytokines
Analysis of the efficacy of the treatment regimen in patients with chronic paraproctitis in terms of the number of indicators different from the normal level showed that the administration of polyoxidonium in addition to the standard treatment regimen allowed to normalize 11.5% of the indicators, 27.0% of the parameters, while 34.5% had no change after the treatment
Summary
В исследовании на основе добровольного согласия приняли участие 60 больных с подтвержденным диагнозом хронического парапроктита в возрасте от 31 года до 60 лет, поступивших для лечения в колопроктологическое отделение ОГБУЗ «Белгородская областная клиническая больница святителя Иоасафа». Пациенты второй группы (n=32) в дополнение к стандартному лечению получали полиоксидоний в дозе 6 мг внутримышечно 1 раз в сутки через день, общий курс 5 инъекций. У всех больных при поступлении производился забор венозной крови, в которой методом проточной цитометрии на аппарате Beckman Culter Epecs XL с моноклональными антителами оценивали содержание клеток с фенотипами CD3+CD19-, CD3+CD4+, CD3+CD8+, CD3+HLADR+, CD3+CD16+56+, CD3-CD16+56+. На десятые сутки лечения проводился повторный забор 10 мл венозной крови у каждого пациента с целью оценки изменений иммунного статуса. Степень иммунных расстройств (СИР) для иммунологических показателей рассчитывали по формуле [6]: показатель конкретного больного − 1 х 100%. Поэтому для сравнения иммунологических показателей контрольной и изучаемых групп использовался непараметрический вариант критерия Ньюмена-Кейлса [3, 4].
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