Резюме

Глущенко В.Ю. Стан інтерфероногенезу у хворих молодого віку із хронічним некалькульозним холециститом з гіпертонічною хворобою в залежності від інфекційного агента.

В роботі досліджено рівень інтерферонів (ІФН) у крові хворих молодого віку з хронічним некалькульозним холециститом у сполученні з гіпертонічною хворобою. У цих пацієнтів реєструється зни­жен­ня продукції α- і γ-ІФН. При цьому ви­яв­лено, що головна роль недостатності системи ІФН належить хворим з бактеріально-грибковою і асоціацією бактеріальної флори.

Ключові слова: хронічний некалькульозний холецистит, гіпертонічна хвороба, патогенез, інтерферони, збудник.

Резюме

Глущенко В.Ю. Состояние интерфероногенеза у больных молодого возраста с хроническим некалькулезным холециститом в сочетании с гипертонической болезнью в зависимости от инфекционного агента.

В работе исследован уровень интерферонов (ІФН) в крови больных молодого возраста с хроническим некалькулезным холециститом в сочетании с гипертонической болезнью. У этих пациентов региструется сни­жен­ие продукции α- и γ-ІФН. При этом выявлено, что главная роль недостаточности системы ІФН принадлежить больным с бактериально-грибковой и асоциацией бактериальной флоры.

Ключевые слова: хронический некалькулезный холецистит, гипертоническая болезнь, патогенез, интерфероны, возбудитель.

Summary

Gluschenko V.Y. State of interferons in young patients with chronic acalculous cholecystitis in combination with arterial hypertension depending on the infectious agent.

The article presents data on the lipid profile in young patients with chronic acalculous cholecystitis in combination with arterial hypertension. Lipid profile of these patients were characterized an increase in total cholesterol and low-density lipoprotein, against normal levels of triglycerides and high-density lipoprotein.

Key words: chronic acalculous cholecystitis, hypertension, interferons, infectious agent.

UDC 616.366-002+616.12-008.331.1

STATE OF INTERFERONS IN YOUNG PATIENTS WITH CHRONIC ACALCULOUS CHOLECYSTITIS IN COMBINATION WITH ARTERIAL HYPERTENSION DEPENDING ON THE INFECTIOUS AGENT

V.Y. Gluschenko guska2000@meta.ua

SE "Lugansk State Medical University"

The goal of the research was studying of the state of interferonogenesis for  young patients  with сhronic acalculous cholecystitis (CAC) and hypertensive disease (HD) depending on the infectious agent in the gall bladder.

There were 130 patients with CAC in combination with HD of the II stage in the age from 18 to 45 years under care (classification of WHO, 1989). Patients who had no carbohydrate metabolism disorders, thyroidea diseases, adrenalopathy, secondary arterial hypertension took part in the examination. There were 51 men (39,3%) and 79 women (60,7%) among the examined patients. Duration of comorbide pathology according to the data of medical documents was from 2 to 7 years, on the average 4,2±0,5 years. Patients that were under care had CAC mainly in the phase of the moderate recrudescence; according to the data of anamnesis the amount of the previous  recrudescences of CNC was 2-3 times in a year. 116 (89,3%) patients had gradual beginning of disease. According to the data of anamnesis patients connected progression of recrudescences with eating of rich,  fried food and also with nervous overstrain.

Diagnoses verification was made on the basis of anamnesis data, clinical picture,  results of complex clinical, laboratory and instrumental examinations. The diagnosis of HD was made in accordance with criteria of WHO and European Society of Hypertension/European Society Cardiology Guidelines Committee (2007), the stage of arterial hypertension (AH) was determined in accordance with classification of target lesions. The diagnosis of gallbladder dyskinesia and CNC was made in accordance with present protocols of working classification of CNC and gallbladder dyskinesia classification (I.I.Dekhtiarova, 1999).

Concentration of α-IFN and γ-IFN in blood was determined by means of enzyme multiplied immunoassay (EMI) using the test kits produced by research and manufacturing combine "Diagnostic systems" (RF -N.Novgorod) that were certificated in Ukraine.

As a result of undertaken testing it was set that in the group of patients with the presence only of pure culture of bacterium the level of α-IFN on the average was 14,5±0,4 pg/ml (at the norm of 20,1±0,24pg/ml; р<0,05), that was belower norm in 1,4 times. Patients with the presence of microbal association (two and more  bacteria strains) had the concentration of α-IFN corresponding to 10,2±1,8 pg/ml, id est the multipleness of reduction to content of α-IFN in blood was almost twice (р<0,05).

The most considerable decrease of α-IFN concentration  in blood was in the group of examined patients with the selection of bacteria association  and mycetes in the inoculation of fel for CAC in combination with HD. So, the content  of cytokine was in 2,5 times less referential norm and  it was 8,1±1,1 pg/ml (р<0,01) . Thus, less expressive suppression of the system interferonogenesis  was diagnosed for patients with revealed bacterial pure culture.

In the period of recrudescence of chronic pathology of biliary tract for patients with CAC the concentration of γ-IFN in blood was considerably decreasing. So, the content of γ-IFN for patients with a pure culture bacterial flora was decreasing in 1,11 times (р>0,05), for examined patients with microbial association it was decreasing  in 1,5 times (р<0,05), and at presence of selection of bacterial mycotic association it was decreasing in 1,7 times (р<0,05). The analysis showed that the most considerable decrease  of γ-IFN  had patients with bacteria and mycetes in the fel.

Thus, in the result of research it was revealed that the leading role of insufficiency of the system IFN belonged to the patients with bacterial mycotic and association of bacterial flora.