FORECAST OF THE OUTCOME OF SURGICAL TREATMENT OF PATIENTS WITH AORTIC ANEURISM TO CHANGE THE CONCENTRATION OF VESSEL ENDOTHELIUM GROWTH FACTOR (VEGF) AND CONTENT OF IMMUNOLOGICAL MARKERS
Summary. Despite all the successes of surgical treatment of patients with aortic aneurysm, there are a number of questions, the search for answers to which remains relevant now. It is important to have prognostic markers for assessing postoperative complications.
The aim. To determine the diagnostic and prognostic significance of indicators characterizing immunoresistance, the degree of adaptive reactions and the regenerative ability of immunophysiological factors affecting the outcome of the disease.
Materials and methods. The study examined 23 patients with vascular pathology (13 patients with aortic aneurysm (chest and abdominal) and 10 patients with coronary heart disease (CHD)).
Results and discussion. The determination of significant biomarkers in patients with aortic aneurysms revealed violations of the barrier function of neutrophil phagocytosis. An increase in the oxidative activity of SP, % in the spontaneous NBT-test to (20,2 ± 2,2)% at a reference value of (10 ± 1,1)% and a 1,2-fold increase in the number of cells that absorbed the dye after stimulation with zymosan (ST). In all examined patients with aortic aneurysm, CD2+ and CD3+ stimulation was observed. The decrease in CD4+ and CD8+ in 1,7 and 1,6 times, respectively, in all terms of the survey. A significant increase in cytotoxic factors opsonized by the C3 complement factor by 1,5 times was revealed. In the preoperative period revealed a multiple increase in the concentration of IL-6 (in 60 times) and IL-10 (in 50 times) in all patients with aortic aneurysm. In 3 patients with negative dynamics of the course of the disease (exitus), an extremely low level of VEGF concentration was detected. In all patients with stratified aortic aneurysms, preoperatively reduced AChE activity was observed, an increase in creatinekinase activity to 410 U/l at a reference value of (85 ± 54) U/l, and a decrease in ceruloplasmin content to 214.4 mg/l compared to the reference group (315.0 ± 45.2) mg/l.
Conclusion. As significant biomarkers characterizing the severity of the condition of patients with aortic aneurysm, the level of vascular endothelial growth factor (VEGF), cytokines, as well as changes in the activity of the enzyme acetylcholinesterase (AChE) can be used.
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