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Khirurgii

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Year 2013 Vol. 21 No 4

GENERAL AND SPECIAL SURGERY

Y.S. VINNIK, S.S. DUNAEVSKAYAY.S. VINNIK, S.S. DUNAEVSKAYA

ESTIMATION OF SEVERITY OF PANCREATIC IMMUNODEFICIENCY

SBEE HPE “Krasnoyarsk State Medical University
named after prof. V.F. Voyno-Yasenetsky”
The Russian Federation

Objectives. To study the disturbances of the immune status in patients with severe acute pancreatitis.
Methods. 40 patients with the diagnosis of severe acute pancreatitis have been examined. The patients of 23-76 years old were included in the study. Phenotype of lymphocytes was evaluated by the indirect fluorescence method with monoclonal antibodies and the determination of receptors: CD3, CD4, CD8. The concentration of serum immunoglobulins A, M, G was determined by immunoprecipitation method on the agar gel. Peripheral blood’s functional activity of phagocyte was studied by means of flow cytometry. The percentage of phagocytic cells – phagocytosis index and an average number of phagocyted particles have been calculated by means of “Latex-test”. The reduction of laboratory index of the immune status was taken into consideration. The decreasing of index (from 15% up to 30%) from the lower limit of norm was considered as the first degree of immune insufficiency, within 31-60% – as the second degree of insufficiency, lower than 61% – as the third, the heaviest degree of immunity disturbances.
Results. It has been established that considerable deviations of immunogram indices were registered in case of severe acute pancreatitis. It was expressed in the reduction of the number of T helper cells to the third degree (Th-3) and insignificant reduction of the suppressor T cells to the first degree (Ts-1). The reduction of the cellular component deficiency – Th-1 Ts-1 occurred in dynamics. The indices of a phagocytal link had decreased by the 7th day. Increase was registered at admission of IgA, the other changes in a humoral link were not revealed.
Conclusions. In the patients who had a severe acute pancreatitis, immune deficiency has been detected and cardinal changes were observed in the cellular components of the immune system. Deviations of immunogram indices have already been registered at the moment of hospital admission which could be probably connected with the secondary immunodeficiency developed earlier.

Keywords: acute pancreatitis, immunodeficiency, severe course
p. 40 – 44 of the original issue
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Address for correspondence:
660022, Rossiiskaia Federatsiia, g. Krasnoiarsk, ul. Partizana Zhelezniaka, d. 1, GBOU VPO «Krasnoiarskii gosudarstvennyi meditsinskii universitet im. prof. V.F. Voino-Iasenetskogo», kafedra obshchei khirurgii,
e-mail: Vikto-potapenk@yandex.ru,
Dunaevskaia Svetlana Sergeevna
Information about the authors:
Vinnik Y.S. Honored Scientist of the Russian Federation, MD, professor, a head of the general surgery chair of SBEE HPE “Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky”.
Dunaevskaya S.S. PhD, an associate professor of the general surgery chair of SBEE HPE “Krasnoyarsk State Medical University named after prof. V.F. Voyno- Yasenetsky”.
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