Abstract
The study aimed to compare the effectiveness of various pharmacotherapy regimens for infertility of tubo-peritoneal genesis. Under constant supervision were 96 patients referred to the hospital for diagnostic laparoscopy for infertility of tubo-peritoneal genesis, divided equally into 4 groups depending on the pharmacological treatment methods: the 1st group received basic pharmacotherapy (BPT) after endoscopic surgery (antibacterial, antifungal, vitamin therapy). Patients of groups 2-4, in addition to BPT, received Hepon, Cycloferon or Lavomax, respectively. The control group consisted of 38 gynecologically healthy women. Laboratory examination was performed within 24 hours after the operation and on the 30th day after BPT. Vaginocervical lavage and plasma were assayed for the activity of lipid peroxidation processes, the state of the antioxidant system, the level of stable nitric oxide metabolites, neopterin, C-reactive protein, cytokines (TNFα, IL-1β, IL-8, IFNγ, IL-18, G-CSF, IL-4, IL-10), immunoglobulins (IgM, IgG, IgA, sIgA), components of the complement system (C3, C4, C5, C5А), phagocytic and oxygen-dependent activity of polymorphonuclear leukocytes. It was established that the use of immunomodulatory and antiviral activity medication with BPT according to the degree of increasing efficiency in the correction of immunometabolic laboratory parameters at the systemic and local level in infertility of tuboperitoneal genesis is as the following sequence: basic pharmacotherapy < basic pharmacotherapy + Hepon < basic pharmacotherapy + Cycloferon < basic pharmacotherapy + Lavomax.
Highlights
The restructuring of the etiological system of infectious and inflammatory diseases of the female reproductive system health that revealed in the last decade indicates the need to change opinions and positions on the influence of conventional-pathogenic bacterial flora in the genesis of this nosology
Microbial associations enhanced the pathogenic characteristics of each individual representative of this association, which in turn leads to increased resistance of microorganisms to external factors, antibiotic therapy is no exception [1, 2]
The triggering mechanism in the development of pelvic inflammatory diseases (PID) is the effect of a microbial fact, while the development of the inflammatory process, as well as its course and outcome are determined by the nature of the pathogen, and by the state of the microorganism, environmental conditions, the presence of somatic pathology, including viral etiology, leading to prolonged persistence of viruses and, as a rule, immune changes occurring against this background
Summary
The restructuring of the etiological system of infectious and inflammatory diseases of the female reproductive system health that revealed in the last decade indicates the need to change opinions and positions on the influence of conventional-pathogenic bacterial flora in the genesis of this nosology. The triggering mechanism in the development of PID is the effect of a microbial fact, while the development of the inflammatory process, as well as its course and outcome are determined by the nature of the pathogen, and by the state of the microorganism, environmental conditions, the presence of somatic pathology, including viral etiology, leading to prolonged persistence of viruses and, as a rule, immune changes occurring against this background. In the genesis of all inflammatory diseases of the female reproductive system, especially chronic diseases of the pelvic organs, there is a violation of local immune mechanisms of anti-infection protection with the protective effect of the endometrium and endosalpinx All this is a trigger factor for the involvement in this process of systemic mechanisms of stabilization of the immune and oxidative homeostasis of the body [6, 9]
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