Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2020 Vol. 28 No 5

UROLOGY

DOI: https://dx.doi.org/10.18484/2305-0047.2020.5.551   |  

S.S. DUNAEVSKAYA, YU.S. VINNIK, A.G. BEREZHNOI

FEATURES OF ENDOTHELIAL DYSFUNCTION IN THE DEVELOPMENT OF HEMORRHAGIC COMPLICATIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk,
The Russian Federation

Objective. To identify features of the endothelial dysfunction in the development of postoperative hemorrhagic complications in patients with urolytiasis.
Methods. A study of patients (n=174) with urolithiasis was conducted. Patients were divided into two clinical groups: group I 93 patients, with an uncomplicated postoperative course; group II 81 patients with the developed hemorrhagic complications. In the preoperative period and 3 days after the operation, the expression of CD38 and CD31 on lymphocytes was evaluated; counting the number of membranes of released microparticles, and also estimating blebbing of peripheral blood lymphocytes.
Results. In the preoperative period, an increase in expression of CD 38 and CD 31 lymphocytes was recorded, it was more pronounced in the II clinical group. In patients of clinical group I, the number of lymphocytes in the initial and terminal blebbing state was within the mean values of the control group. In clinical group II, there was a significant increase in these indicators. The number of free lymphocyte-derived microparticles in the peripheral blood of patients was statistically increased in clinical group II and was 874 [643; 1095]. Analyzing the data obtained in the postoperative period, a statistically significant increase in expression of CD 38 and CD 31 lymphocytes prevailing in the II clinical group was revealed, the number of lymphocytes with an initial blebbing state was increased (7.61 and 9.26, respectively). The end-state blebbing lymphocyte score was increased in both clinical groups (8.55 and 19.17, respectively).
Conclusion. Thus, the endothelial insufficiency develops inpatients uitiurolithiasis in the postoperative period patients with urolithiasis. However, in the development of hemorrhagic complications, the mechanism and expression of intercellular communication in the pathogenesis of endothelium dysfunction formation is considered to be significantly different, which should be taken into account in the course of operative treatment and administration of hemostatic therapy in the early postoperative period.

Keywords: urolytiasis, hemorrhagic complications, endothelial dysfunction, blebbing, membranes released microparticles
p. 551-557 of the original issue
References
  1. Dutov VV. Distancionnaja udarno-volnovaja litotripsija: nazad v budushhee. RMZh. 2014;(29):2077-86. https://www.rmj.ru/articles/urologiya/Distancionnaya_udarnovolnovaya_litotripsiya_nazad_v_buduschee/ (In Russ.)
  2. Trapeznikova MF, Dutov VV, Rumjancev AA, Tumanjan VG. Distancionnaja udarno-volnovaja litotripsija v lechenii urolitiaza distopirovannyh pochek. Sarat Nauch-Med Zhurn. 2011;7(S2):245-48.
    https://cyberleninka.ru/article/n/distantsionnaya-udarno-volnovaya-litotripsiya (In Russ.)
  3. Zhebentjaev AA. Konservativnoe lechenie i distancionnaja litotripsija pri lechenii mochekamennoj bolezni. Vestn VGMU. 2007;6(3):5-12. https://elib.vsmu.by/bitstream/123/8516/1/vVGMU_2007_3_5-12.pdf (In Russ.)
  4. Hasigov AV, Hazhokov MA, Belousov II, Kogan MI. Ural Med Zhurn. 2013;(4):95-100. Shock-wave lithotripsy or percutaneous nephrolithotomy in large and staghorn stones: technical features and complications. Ural Med Zhurn. 2013;(4):95-100. https://www.elibrary.ru/item.asp?id=20138485 (In Russ.)
  5. Malhasjan VA, Semenjakin IV, Ivanov VJu, Suhih SO, Gadzhiev NK. Complications of percutaneous nephrolithotomy and their management. Urologija. 2018;(4):147-53. doi: 10.18565/urology.2018.4.147-153 (In Russ.)
  6. Zhuravlev VN, Danilov VO, Bazhenov IV, Beresteckij IE, Borzunov IV, Vahlov SG, Makarjan AA. Percutaneous nephrolithotripsy: the algorithm of actions in identifying bleeding from renal vessels. Ural Med Zhurn. 2016;(1):10-13. https://www.elibrary.ru/item.asp?id=25631708 (In Russ.)
  7. Rossolovsky A.N., Chekhonatskaya M.L., Zakharova N.B., Berezinets O.L., Emelyanova N.V. Dynamic evaluation condition of renal parenchyma in patients after external shock wave lithotripsy of kidney stones. Urology Herald. 2014;(2):3-14. doi: 10.21886/2308-6424-2014-0-2-3-14 (In Russ.)
  8. Inzhutova AI, Larionov AA, Salmina AB, Petrova MM. Molecular and cellular mechanisms of endothelial dysfunction in different pathology. report 1. Sib Med Zurn (Irkutsk). 2010;96(5):85-88. https://cyberleninka.ru/article/n/molekulyarno-kletochnye-mehanizmy-endotelialnoy-disfunktsii (In Russ.)
  9. Kondrateva TS, BabincevA AU. Estimation of blebbing-phenomena as a method of diagnostic degree of diabetic polyneuropathy. Vestn Soveta Molodyh Uchenyh i Specialistov Cheljab Oblasti. 2018;3(22):98-102. https://cyberleninka.ru/article/n/otsenka-blebbing-fenomena-kak-metod-diagnostiki (In Russ.)
  10. Tixeira R, Phan TK, Caruso S, Shi B, Atkin-Smith GK, Nedeva C, Chow JDY, Puthalakath H, Hulett MD, Herold MJ, Poon IKH. ROCK1 but not LIMK1 or PAK2 is a key regulator of apoptotic membrane blebbing and cell disassembly. Cell Death Differ. 2020;27(1):102-16. doi: 10.1038/s41418-019-0342-5
  11. Obeidy P, Ju LA, Oehlers SH, Zulkhernain NS, Lee Q, Galeano Niño JL, Kwan RY, Tikoo S, Cavanagh LL, Mrass P, Cook AJ, Jackson SP, Biro M, Roediger B, Sixt M, Weninger W. Partial loss of actin nucleator actin-related protein 2/3 activity triggers blebbing in primary T lymphocytes. Immunol Cell Biol. 2020 Feb;98(2):93-13. doi: 10.1111/imcb.12304
  12. Moroz VV, Salmina AB, Fursov AA, Mihutkina SV, Linev KA, Mantorova NS, Shahmaeva SV, Olhovskij IV, Isakov IV. Rol membrannyh vysvobozhdennyh mikrochastic v patogeneze sistemnogo vospalitelnogo otveta. Vestn Ros Akad med nauk. 2010;(4):3-8. (In Russ.)
  13. Vinnik YuS, Dunaevskaya SS, Antufrieva DA. Deulina VV, Microparticles of lymphocytic origin a pathogenetic marker of necrotizing pancreatitis.. Jeksperim i Klin Gastrojenterologija. 2019;(5):84-90. doi: 10.31146/1682-8658-ecg-165-5-84-90 (In Russ.)
  14. Mobarrez F, Fuzzi E, Gunnarsson I, Larsson A, Eketjäll S, Pisetsky DS, Svenungsson E. Microparticles in the blood of patients with SLE: Size, content of mitochondria and role in circulating immune complexes. J Autoimmun. 2019 Aug;102:142-49. doi: 10.1016/j.jaut.2019.05.003
Address for correspondence:
660077, Russian Federation,
Krasnoyarsk, Partizan Zheleznyak str., 1,
Voino-Yasenetsky Krasnoyarsk
State Medical University,
the General Surgery Department
Named after pr. M.I. Gulman,
tel. office:+963-191-29-70,
e-mail: Vikto-potapenk@yandex.ru,
Dunaevskaya Svetlana S.
Information about the authors:
Dunaevskaya Svetlana S., MD, Professor, the General Surgery Department Named after pr. M.I. Gulman, Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation.
http://orcid.org/0000-0003-2820-4737
Vinnik Yurii S., MD, Professor, Head of the General Surgery Department Named after pr.M.I.Gulman, Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation.
http://orcid.org/0000-0002-8995-2862
Berezhnoi Alexandr G., PhD, Associate Professor of the Department of Urology, Andrology and Sexology, Institute of Post-Educational Training, Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-7487-8671.
Contacts | ©Vitebsk State Medical University, 2007