Одонтогенный синусит – мультидисциплинарная проблема

Abstract

Chronic focal infection is pathologically closely associated with internal pathology and is a serious factor in its aggravation. Systemic inflammatory reactions are associated with metabolic changes, such as oxidative stress, impaired regulatory participation of macro- and microelements with an imbalance in their distribution in biological media. The resulting homeostatic imbalances cannot be ignored by the attraction of chronic foci of infection, such as odontogenic sinusitis. The aim of the study was to substantiate complex approaches to the supervision of patients with chronic odontogenic sinusitis against the background of comorbid multiple chronic focal infection (MCFI). Materials and methods. In patients with chronic odontogenic sinusitis against the background of multiple chronic foci of infection, the activity of systemic inflammatory factors was studied. Levels and ratio of pro- and anti-inflammatory cytokines – interleukins 2, 6, 10, TNF alpha, C-reactive protein in comparison with the oxidation activity of lipids, proteins, low molecular weight thiols, assessment of Zn, Cu, Fe parameters in biological media and hepcidin in blood. In patients with chronic odontogenic sinusitis against the background of MCFI, an increase in the level of pro-inflammatory (TNF alpha, interleukin 6) was found with an imbalance in the distribution of Zn, Cu, Fe with a deficiency of these elements in the intracellular media. Expressed correlations of these changes with the activity of lipid peroxidation and free radical oxidation of thiol compounds were revealed. The data obtained serve as a rationale for the use of antioxidant and mineral replacement therapy in the complex treatment of patients with MCFI.