МЕСТНЫЙ ИММУННЫЙ СТАТУС И ЭТИОЛОГИЧЕСКИЕ ФАКТОРЫ ПРИ ПАРАТОНЗИЛЛИТАХ

Abstract

Paratonsillitis is one of the most common purulent inflammatory diseases, considered as a manifestation of chronic tonsillitis. The aim of the work is to study the state of local immunity by the level of immunoglobulin A in saliva in patients with paratonsillitis and its changes in the treatment process, to determine the level of antistreptolysin-O in serum, as well as to study the etiological factors of paratonsillites in the microbiological assessment of the species composition of flora in smears from the cavity of paratonsillar abscess. Under our observation there were 152: 32 healthy people and 120 patients with paratonsillitis under abecedarian or abscess stage. It was found that in patients with paratonsillitis there is a significant (p<0.001) decrease in the level of secretory immunoglobulin A in saliva, which indicates a violation of local immunity and requires correction. The level of antibodies to streptolysin-O in the serum of patients with paratonsillitis was significantly - 10.25 times higher than in healthy individuals in the control group, which confirms the high streptococcal antigenic load. The results of microbiological examination of smears from the abscess cavity indicated the release of the most frequent pathogens of paratonsillites - Streptococcus β-haemolythicus, Streptococcus Pneumoniae and Staphylococcus Aureus, with bacterial associations prevailing (63.5%). After a course of antimicrobial therapy, supplemented with immunomodulatory agents in the form of bacterial lysates, there was an increase in the level of secretory IgA in saliva in 10-30 days in 3.3-4.5 times. At the same time, the level of antistreptolysin-O significantly decreased. In patients receiving immunomodulatory therapy in the form of bacterial lysates in the complex treatment of paratonsillitis, for the period of observation of 6 months, there was a decrease in the frequency of relapses of the disease by 2 times.