Changes of the oxidant-antioxidant homeostasis and some cytokines in patients with blastomatous jaundice of various severity
Objective. Investigation of state of a free-radical processes, peroxidal oxidation of lipids, аntiradical defense and content of cytokines in the blood serum in patients, suffering blastomatous jaundice.
Маterials and methods. The investigation was conducted in 80 patients, ageing 38- 83 yrs old, who have had blastomatous jaundice preoperatively. All the patients were distributed into three Groups, depending on classification of Е. І. Galperin (2012), for estimation and prognosis of postoperative results. Into the 1-st Group were included 18 (22.5%) patients with jaundice Class А, to the 2-nd Group - 32 (40%) patients with jaundice Class В, and tо the 3-d Group - 30 (37.5%) patients with jaundice Class С. In 68 (85%) patients the Stages III and IV of the disease were diagnosed.
Results. In environment of clinical course of the blastomatous jaundice of all three Classes of severity the content of the middle-molecules peptides and аmmonia in the blood serum of the patients have been enhanced significantly; аntioxidant homeostasis was characterized by enhancement of content of malonic dialdehyde in the blood serum, dienic conjugates, raising activity of cerulloplasmin and lowering - of catalase (р < 0.05); the content of cytokines IL-1β, IL-6 and ІL-8 in the blood serum have been heightened (р < 0.05), while a dynamics of the cytokines ІL-4 and ІL-10 content changes was an adverse one (р < 0.05). Comparison of the median value of the intergroup differences in accordance to Spearman criterion have shown, that the indices of the VEGF level were trustworthily probable in patients, suffering jaundice of Classes A and B (r = -0.90, p = 0.000), of Classes B and C (r = 0.726, p = 0.000), and Classes A and C (r = 0.489, p = 0.041). There was established, that the VEGF level, median value of which have constituted 346 pg/ml, was the only one index, which have had more accuracy, comparing with patients, suffering cancer, or with conditionally healthy persons (the square under the RОС-curve have constituted 0.943, sensitivity - 86.8%, specificity - 82.4%, general accuracy - 82.3%).
Conclusion. Functional disorders of endothelial cells and of a vascular smooth muscle cells, іnduced by a free-radical processes and the antiradical defense system, leads to development of endothelial and vascular dysfunction, which, possibly, іnitiates and induces a vascular hypoactivity and vasodilation, the level of VEGF has more accuracy, comparing with patients, suffering cancer and the conditionally healthy persons.
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