Novosti
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Year 2019 Vol. 27 No 6
SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE
YU.S. VINNIK, R.A. PAKHOMOVA, L.V. KOCHETOVA, G.E. KARAPETYAN
ELECTRONIC MICROSCOPY OF ERYTHROCYTES IN PATIENTS WITH SEVERE OBSTRUCTIVE JAUNDICE OF BENIGN GENESIS
Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk,
The Russian Federation
Objective. To study chemical composition and morphology of an erythrocyte in patients with severe obstructive jaundice.
Methods. Erythrocyte electron microscopy was performed on Hitachi 5500 scanning electron microscope (Japan), the spectral analysis of the peripheral blood erythrocyte composition was calculated using the QUANTAX 70 program in 17 patients with the severe obstructive jaundice and 14 conditionally healthy individuals. The severity of obstructive jaundice was determined by E.I. Halperin (2012). The study included the patients with severe obstructive jaundice, with clinical signs of endotoxemia and hepatic cell failure. The level of bilirubin in the studied patients was higher than 180 μmol / L, the level of alanine and aspartic transaminases was 2-3 times higher than normal.
Results. In patients with severe obstructive jaundice, the erythrocyte cytoskeleton changed: from a biconcave spherocyte, it turned into a domed stomatocyte. The oxygen concentration in the cell significantly decreased and reached its minimum value, 14.9%. Hypokalemia increased inside the cell, the content of sodium increased to 7.1% and calcium ions to 2.9%, which “made the cell heavier”, retaining water in it and, most likely, led to a change in the shape of the red blood cell and its functional capabilities. Significant changes in the concentration of carbon and nitrogen inside the cell were not detected.
Conclusions. In patients with severe obstructive jaundice with marked phenomena of endogenous intoxication, a cascade of biochemical reactions is launched. An increase in the content of chemical elements inside the cell holding water, apparently, leads to a change in the morphology of the red blood cell, its molecular structure and functional capabilities. A change in the erythrocyte cytoskeleton disrupts its oxygen transport function, and a decrease in the oxygen content in the cell exacerbates tissue hypoxia.
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660022, The Russian Federation,
Krasnoyarsk, Partizan Zheleznyak Str., 1,
Krasnoyarsk State Medical University
Named after Prof. V.F. Voino-Yasenetski,
Department of General Surgery.
e-mail: yuvinnik@yandex.ru,
Yurii S. Vinnik
Vinnik Yurii S., MD, Professor, Head of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-8995-2862
Pakhomova Regina A., MD, Assistant of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-3681-4685
Kochetova Lyudmila V., PhD, Professor of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0001-5784-7067
Karapetyan Georgii E., MD, Professor of the Department of General Surgery named after Prof. Gulman, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetski, Krasnoyarsk, Russian Federation.
https://orcid.org/0000-0002-1216-2029
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