FEATURES OF THE DYNAMIC OF ACUTE C-REACTIVE PROTEIN AND INDICATORS OF THE BODY’S IMMUNE SYSTEM AND THEIR RELATIONSHIP WITH THE CLINICAL PICTURE IN ELDERLY PATIENTS WITH ULCERATIVE GASTROINTESTINAL BLEEDING
The aim. Improve the effectiveness of treatment of elderly patients with ulcerative gastrointestinal bleeding by studying the dynamics of the level of C-reactive protein (CRP) and immune system parameters, their relationship with the clinical picture.
Materials and methods. 35 elderly patients in the period from 2019 to 2021 (according to the WHO classification — 61-90 years) with ulcerative gastrointestinal bleeding complicated by cardiovascular pathology. The gender distribution is as follows: men — 19 (54%), women — 16 (46%). The average age of the patients was 76.3 years. This category of patients was divided according to the methods of treatment of concomitant cardiovascular pathology: group A — patients who received therapy according to the standard scheme (n = 20), B — double (n = 15). As a control category of patients (n = 50) was selected. There are relatively healthy (donors), who were similar to the study group in terms of age, gender, and the method for determining indicators.
Results. The state of local endoscopic hemostasis in group “A” was investigated: Forrest II was detected in 14 (70%) patients, Forrest III — in 6 (30%) patients; in group “B”: Forrest I — in 7 (47%) patients, Forrest II — in 8 (53%) patients. These results indicate that using of dual therapy leads to a change in the rheological properties of blood, which, in turn, leads to a decrease in the stability of local endoscopic hemostasis and an increased risk of recurrent bleeding compared with standard antihypertensive therapy (the studied groups are represented, respectively, 100% each).
Conclusions. We have analyzed the C-reactive protein, interleukin-6 and interleukin-4. The main result of the study was the identification of the dynamics of markers in groups A and B. On the seventh day, normalization of these indicators was not revealed (in group B, it was especially pronounced). But the state of the latter was influenced by the therapy of concomitant pathology in patients with cardiovascular pathology. The clinical significance of immune indicators has been proven in many clinical examples and can be one of the objective criteria for assessing the patient’s condition, predicting the disease and correcting the treatment started.
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