Changes in the Dynamics of the Functional Activity of Blood Granulocytes in Patients With Pancreatic Necrosis.

Abstract

The purpose of research. Predicting risk of infection of acute destructive pancreatitis.
 Material and Methods. The dynamics of functional activity of granulocytes in 27 (58,7%) patients with sterile and 19 (41,3%) patients with infected pancreatic necrosis. An objective assessment of the severity of their condition carried out by performed using of the scale of the integrated assessment APPACHE-II. The exclusion criterion from the study was the revealing of accompanying acute and chronic diseases.
 Results.Scale APPACHE-II can be used mainly for screening assessment of the degree of polyorgan insufficiency, as well as predicting the development of infected pancreatic necrosis forms, but, unfortunately, only in the later stages of development of pathological process. Dynamics of changes in the functional activity of leukocytes in patients with pancreatic necrosis can be used as an additional test, which characterizes the moment of transition of sterile pancreatic necrosis to infected, and, consequently, in deciding on the timing of terms and nature of performance of operational allowance.
 Conclusions. 1. In patients with sterile pancreatic necrosis (SPN) after a moderate decrease in the activity of myeloperoxidase (MPO), the content of the cation proteins (CP) in the first three days in subsequent periods of observation, on the background of complex conservative therapy, noted, compared with the established "Normal" gradual increase or stabilization at close to the indicators of the functional activity of neutrophils. The activity of KF and alkaline phosphatase from patients with SPN, after the increase in performance in the first 11 days, then gradually declines, reaching the normal level. 2. Patients with infected pancreatic necrosis(IPN) sharply, starting with 11 days of the study, by 35-40%, reduce the activity of MPO and the content of CB and Acid Phosphatase activity and Alkaline Phosphatase, on the contrary, it had progressively pronounced growth after 11 days by 35-40%.