[Aetiology and pathogenesis of damages to blood vessels in drug addicts].

The article deals with the problems concerning aetiology and pathogenesis of damages to blood vessels in patients practicing parenteral administration of surrogates of narcotic substances. In order to clinically and experimentally study the pattern of morphological alterations in the area of narcotic substances administration and to work out an appropriate classification of the forms and stages of development of the pathological process, the authors analysed the clinical course of vascular lesions and complications thereof in a total of 244 drug abusers having parenterally administered surrogates of narcotic substances and undergoing treatment at the Department of Vascular Surgery of the Municipal Clinical Hospital of the city of Almaty. Additionally, experimental studies were carried out on 16 rabbits with the induced model of parenteral administration of surrogates of narcotic substances, thus making it possible to study the degree of their effect and to confirm the theory of a chemical impact of the homemade drugs on the vascular wall. The findings of the carried out studies enabled us to single out the following clinical stages of vascular lesions: stage I - the initial stage of cicatricial-and-ulcerous lesions formation, stage II - formation of cutaneous-and-vascular fistulas, stage III - the stage of complications characterized by development of health-hazardous vascular lesions, i. e., arterial and venous thromboses of the major vessels, as well as arrosive bleedings. It was noted that more than 50% of patients were admitted to the clinic presenting with the third stage of vascular lesions. The experimental part of the study included 64 experiments on 16 rabbits (one experiment per each paw of the animal). The laboratory animals were subdivided into three groups. The first experimental group consisted of the rabbits with a mechanically inflicted injury to the vessels. The second and third experimental groups were composed of the rabbits having received injections simulating various surrogates of narcotic substances. It was experimentally confirmed that the dominating factor was a chemical injury - a locally irritating effect on the vascular wall and paravasal tissues, while the process of the damaged area infection turned out to be secondary, thus belonging to a complication of the chemical injury concerned.