SEPSIS IN PATIENTS WITH COMPLICATED SYNDROME OF DIABETIC FOOT – ОXIDANT STRESS OF ORGANISM
Introduction. Purulent diseases are noted in more than 35% of patients in surgical stationaries, of whom a special group is presented when sepsis occurs on the complicated diabetic foot syndrome (DFS) background. The organism reaction towards septic process presents as changes in metabolic processes, in regulation of which peroxidal oxidation of lipids (POL) and system of antioxidant defense (SAD) play significant role.
Маterials and methods. There were examined in dynamics 724 patients, suffering complicated DFS. The POL state was estimated, basing on analysis of its primary and secondary products – dienic conjugates, malonic dyaldehyde, and Schiff bases.
Results. There was established, that in patients, suffering complicated DFS or sepsis, the changes in the POL products contentin the blood sera while admittance to hospital have appeared trustworthy (р< 0.05) in sepsis, and more pronounced, than in complicated DFS without sepsis.
Discussion. Аnalysis of the data obtained witnesses, that the sepsis course severity in patients with complicated DFS depends on the state of a free-radical oxidation of lipids. Results of the investigation also trusts, that primary and secondary products of POL constitute objective markers of the endogenous intoxication severity and determine the organism oxidant stress. In system of complex therapy in such patients antioxidants must be applied as one of variants of pathogenetically substantiated intensive therapy.
2. Mjurrej P. Molekuljarnye i nemolekuljarnye metody v diagnostike infekcij krovotoka. Simpozium: «Sepsis i infekcii krovotoka». XVII Mezhdunarodnіj kongress MAKMAH po antimikrobnoj terapii. Moskva, 22 maja 2014. [In Russian].
3. Dellinger RP, Levy MM, Rhodes A. Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013 Feb.; 41(2):580-637.
4. Podilchak MD, Makar DA, Ohonovskyi VK, Kordoba BM. Perekysne okyslennia lipidiv ta aktyvnist peroksydazy syvorotky krovi u khvorykh z hniino-zapalnymy urazhenniamy. Klinichna khirurhiia. 1995;(2):11-12. [In Ukrainian].
5. Shapoval SD. Perekisnoe okislennja lipidov i sostojanie antioksidantnoj sistemy pri sepsise u bolnyh s gnojno-vospalitelnym porazheniem mjagkih tkanej. Klіnіchna hіrurhіia. 1998;(11):15-6. [In Russian].
6. Nekrasov YeV. Metody analiza perekisnogo okislenija lipidov v mediko-biologicheskih issledovanijah. Bjulleten. 2012; vyp. 46:98-108. [In Russian].
7. Bone RC. The pathogenesis of sepsis. Ann Int Med. 1991;115:459-69.