Abstract
Treatment of complications of peptic ulcer disease is an urgent problem in abdominal surgery due to the high prevalence of bleeding (19-57) and perforations (3-14 cases per 100,000 population). The objective of the study was to assess the possibility of predicting the development of ulcerative disease complications determining the ratio of the level of melatonin receptors (MT1/MT2) in the duodenal mucosa. Methods and materials . 56 patients with different course of peptic ulcer disease were examined. All patients underwent esophagogastroduodenoscopy with biopsy of the bulb duodenum. Biopsies were analyzed on a flow cytometer. The results were statistically processed. Results. The ratio of melatonin receptors MT1/MT2 significantly differed in the group of patients with bleeding and in the group with perforation. During the statistical analysis, it was found that at a value of MT1/MT2≥1,7, it is possible to assume the development of complications in the patient in the form of perforation or bleeding. Conclusion. The method of determining the ratio of melatonin receptors (MT1/MT2) in patients with complicated peptic ulcer disease can be used for prediction the risk of complications.
Highlights
The OBJECTIVE of the study was to assess the possibility of predicting the development of ulcerative disease complications determining the ratio of the level of melatonin receptors (MT1/MT2) in the duodenal mucosa
The ratio of melatonin receptors MT1/MT2 significantly differed in the group of patients with bleeding and in the group with perforation
The method of determining the ratio of melatonin receptors (MT1/MT2) in patients with complicated peptic ulcer disease can be used for prediction the risk of complications
Summary
Цель работы – оценка прогностической значимости соотношения мелатониновых рецепторов (МТ1/МТ2) у пациентов с осложненной язвенной болезнью двенадцатиперстной кишки. Для определения рецепторов на поверхности клеток были использованы первичные специфические антитела к МТ-рецепторам и коммерческие вторичные антитела, меченные флуоресцеинизотиоцианатом (goat antirabbit FITC Ig G+M производства Becton Dickinson). При статистическом анализе было выявлено, что в группах пациентов с перфорацией и кровотечением распределение соотношения МТ1/МТ2 соответствует закону нормального распределения. Несмотря на отличающиеся значения показателя МТ1/МТ2 в группе пациентов с кровотечениями – 4,33 (2,76) – от таковых в группе с перфорацией – 2,68 (1,3), эти отличия являются статистически незначимыми (p=0,056), что позволяет объединить эти группы – с осложнениями язв вместе и провести ROC-анализ для определения чувствительности и специфичности прогностической системы. 2. При выявлении соотношения МТ1/МТ2≥1,7 можно прогнозировать развитие у данного пациента осложнений язвенной болезни двенадцатиперстной кишки в виде кровотечения или перфорации
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