КОМПЛЕКСНЕ ЛІКУВАННЯ ГЕНЕРАЛІЗОВАНОГО ПАРОДОНТИТУ В НАРКОЗАЛЕЖНИХ, ХВОРИХ НА ТОКСИЧНИЙ ГЕПАТИТ

Abstract

Generalized parodontitis (GP ) occurs and proceeds against a background of violations of the indices of local immunity of the oral cavity of patients. Modern ideas about the causes of inflammatory parodontal diseases are based on the violation of local and general immune mechanisms, sensitization of the organism to antigens produced by pathogenic microorganisms, the presence of somatic pathology. The use of narcotic drugs causes disturbances in the functioning of the immune system. For the complex treatment of inflammatory parodontal diseases, the use of a drug with immunomodulating activity - nuklex and agents, which reduces the amount of oxidized stress products and has a hepatoprotective effect – mexidol is suggested.The aim of the study – to learn the dynamics of general and local immunity indices (for the concentration of cytokines) in patients with generalized parodontitis with toxic hepatitis in opioid dependence during complex treatment.Materials and Methods. 65 patients with GP were examined in the stage of unstable remission: 19 women (29.2 %) aged 20 to 45 years and 46 men (70.8 %) aged 19 to 47 years. All patients are on dispensary supervision with an expert in narcology about opioid addiction. At the stomatologic examination, GP of the second degree, toxic hepatitis is established. To determine the cytokine profile, samples of blood serum and mixed saliva were used in drug addicts, patients with Hepatitis B with toxic hepatitis, and healthy donors (reference norm).Results and Discussion. Development of GP , especially in persons with toxic lesions (drug addiction), is accompanied by significant changes in the state of immune mechanisms of oral protection, which are manifested in local changes in the composition of gum cells, as well as the content of immunoglobulins and cytokines in the saliva. As a result of the conducted studies, before the beginning of preventive treatment, an increase in the level of IL-6, IL-8 and IL-10 was observed against the background of a decrease in γ-IFN. After finishing the treatment in patients with GP with opioid dependence with toxic hepatitis, there was an improvement in the indices of the studied cytokines (IL-6, IL-8, γ-IFN and IL-10). At the same time, a more pronounced positive dynamics of these indices was manifested in patients, an additional combination of nucleax and mexidol was taken.Conclusions. To study the activity of local immunity in drug-dependent patients with toxic hepatitis, it is expedient to determine the level of cytokines by a non-invasive method. Imbalance of pro-inflammatory and anti-inflammatory cytokines is considered as a reflection of the inflammatory and autoimmune process. In the treatment of generalized parodontitis with the inclusion of a combination of nucleic acid and mexidol, the production of cytokines is restored. The use of this combination reduces the destructive-inflammatory process in the parodontium and the severity of immunodeficiency.