CHANGES IN THE OXYGEN TRANSPORT FUNCTION AND ENERGY BALANCE IN RED BLOOD CELLS IN EPISTAXIS PATIENTS

T S Kolmakova,N V Boiko,O B Smirnova,V V Bykova

doi:10.25207/1608-6228-2017-24-6-71-77

Abstract

Aim. To study the oxygen transport function in red blood cells and energy balance in patients suffering from epistaxis of various progress severities. In case of epistaxis a single blood loss is insignificant, yet in case of recurrent epistaxis there is a threat of a tissue hypoxia development. However no indicator blood values demanding transfusion therapy exist these days. This is a study of the blood oxygen transport function and energy balance in the red blood cells in those suffering from single epistaxis, recurrent moderate epistaxis and recurrent severe epistaxis. Materials and methods. In patients’ red blood cells a contents of 2.3-diphosphoglyceric acid (2.3-DFG) and hemoglobin oxygen affinity (Р50) were estimated; energy balance was assessed by the activity of glucose-6-phosphate-dehydrogenase (G-6-FDG), lactate-dehydrogenase (LDG), as well as by the lactate and pyruvate contents in the red blood cells and plasma. Tissue hypoxia severity was assessed by the lactate/pyruvate ratio in blood plasma. Results. It has been determined that in case of single epistaxis the studied parameters do not differ from normal ranges. In case of recurrent epistaxis the level of hemoglobin and P50 goes down, plasma LDG activity goes up, the pyruvate content goes down, while plasma lactate retains within the normal ranges. Conclusion. The stated changes in the carbohydrate metabolism in the red blood cells and blood plasma of patients suffering from severe recurrent epistaxis suggest a breakdown of compensatory mechanisms, which manifests itself in the reduced cell energy reserve and disturbed red blood cell membranes. The obtained data testify that the severity of the state of patients suffering from epistaxis is not only defined by a quantitative loss of red blood cells and hemoglobin, but also by the adaptive capacities of the body, which determine its resistance to hypoxia. The guide link in the pathogenesis of disturbed gas transport function of blood in patients suffering from epistaxis is metabolic acidosis developing as a consequence of tissue hypoxia.

Highlights

In case of recurrent epistaxis the level of hemoglobin and P50 goes down, plasma LDG activity goes up, the pyruvate content goes down, while plasma lactate retains within the normal ranges
The stated changes in the carbohydrate metabolism in the red blood cells and blood plasma of patients suffering from severe recurrent epistaxis suggest a breakdown of compensatory mechanisms, which manifests itself in the reduced cell energy reserve and disturbed red blood cell membranes
The obtained data testify that the severity of the state of patients suffering from epistaxis is defined by a quantitative loss of red blood cells and hemoglobin, and by the adaptive capacities of the body, which determine its resistance to hypoxia

Summary

ОРИГИНАЛЬНЫЕ СТАТЬИ

Федеральное государственное бюджетное образовательное учреждение высшего образования «Ростовский государственный медицинский университет» Министерства здравоохранения Российской Федерации, пер. Изучить кислородтранспортную функцию эритроцитов и энергетический обмен у больных с носовыми кровотечениями (НК) различной степени тяжести. Проведено изучение кислородтранспортной функции крови и энергетического обмена эритроцитов у больных с однократными носовыми кровотечениями, рецидивирующими средней тяжести и тяжелыми кровотечениями. В эритроцитах определяли содержания 2,3-дифосфоглицериновой кислоты (2,3-ДФГ), сродство гемоглобина к кислороду (Р50); энергетический обмен оценивали по активности глюкозо-6-фосфат-дегидрогеназы (Г-6-ФДГ), лактатдегидрогеназы (ЛДГ), лактата и пирувата в эритроцитах и плазме крови. У больных с тяжелыми рецидивирующими НК наблюдается как снижение энергетического резерва клеток, так и изменение состояния мембран эритроцитов. Тяжесть состояния больных с НК определяется не только количественными потерями эритроцитов и гемоглобина, но и снижением адаптационных возможностей организма к гипоксии. Изменения кислородтранспортной функции и энергетического обмена в эритроцитах у больных с носовыми кровотечениями. Federal State Budgetary Educational Institution of Higher Education Rostov State Medical University of the Ministry of Healthcare of the Russian Federation, Nahichevansky av., 29, Rostov-on-Don, Russia, 344022

Materials and methods

Results

Conclusion

Результаты и обсуждение

Группы обследуемых

Группы обследованных