Purpose: To study activity of systemic inflammatory reaction in patients with obliterating trombongite critical ischemia of lower extremities.

Materials and methods: Activity of systemic inflammatory reaction was studied based on the determination of the amount of systemic inflammatory mediators and clinical symptoms in 86 patients with developed critical ischemia of extremities against the background of obliterating thrombangite. Average age of patients 38,4 years, average duration of the disease 5,7 years, time passed from the development of the critical ischemia till the admission to the clinic 3,1 months. In the anamnesis of the patients there was indicated chronic nicotine intoxication, rheumatism, cold and wet working conditions, frostbiting were of significance. Clinically, cooling in the extremities, cyanosis, reddening and firmness along the superficial veins, and necrotic wounds on fingers draw attention. In a group of patients, a wound was located on the anterior or lateral surface of the leg.

On the admission of patients to the clinic, there was taken blood on an empty stomach in the morning for the biochemical examination, such inflammatory indicators as circulating immune complex, sialic acid, seromucoids, C-reactive protein and fibrinogen were determined. According to the obtained results were compared with the results of blood analysis of 27 actually healthy persons.

Result: C-reactive protein was negative in the blood of actually healthy individuals. The fibrinogen content was 13,56± 0,27 mg, circulating immune complex 86,4±3,2 %, sialic acids 223,9± 6,7 u., seromucoids 228,2± 7,8 u.. In the patients of the control group, in 81 patients at the moment of admission to the clinic C-reactive protein of the blood was (+++) and (++++),in 5 patients ( - ) and weakly positive. The fibrinogen amount was 18,24±0,27 mg, с circulating immune complex 119,1± 5,7%, sialic acids 283,1±5,4 u., seromucoids 279,3±4,8 u.. At early stages of critical ischemia, the content of inflammatory mediators is often higher, despite the low level of inflammation indicators in patients that have taken certain treatment, the indicators are higher than in actually healthy persons.

Conclusion: Taking into consideration the high activity of systemic inflammatory mediators in the control group, it is reasonable to use anti-inflammatory therapy components (hormone-therapy, immune-therapy, laserotherapy) in the pathogenetic treatment in addition of surgical operation.

Date: 2014-12-28; view: 790