Gajiyev J N, Tagiyev E G, Gadjiyev N J
Klin Khir. 2016 Feb(2):24-7.
The results of surgical treatment of 137 patients, suffering obturation jaundice of non-tumoral etiology, were analyzed. In all the patients the cause of obturation jaundice was choledocholithiasis. Roncoleukin was infused intravenously additionally in a complex of therapy. A degree of hepatic dysfunction was determined, taking into account the cholestasis markers. In 23 patients purulent cholangitis have occurred on background of obturation jaundice. Concentration of cytokins TNF-α, IFN-γ, IL-1, IL-2, IL-4, IL-6, IL-10 in sera were determined, using immunoassay analysis. The cytokins dysbalance severity preoperatively and dynamics of its changes have depended upon the hepatic dysbalance degree and presence of purulent cholangitis; a dysbalance is deeper, when the hepatic dysfunction is higher. Application of pathogenetically substantiated purposeful cytokinotherapy, including roncoleukin, have promoted the cytokins dysbalance elimination and improvement of the patients treatment results.
分析了137例非肿瘤病因性梗阻性黄疸患者的手术治疗结果。所有患者梗阻性黄疸的病因均为胆总管结石。在综合治疗中额外静脉输注龙介白素。考虑胆汁淤积标志物来确定肝功能障碍程度。23例患者在梗阻性黄疸基础上发生了化脓性胆管炎。采用免疫分析测定血清中细胞因子TNF-α、IFN-γ、IL-1、IL-2、IL-4、IL-6、IL-10的浓度。术前细胞因子失衡的严重程度及其变化动态取决于肝功能失衡程度和化脓性胆管炎的存在情况;肝功能障碍越严重,失衡越严重。应用包括龙介白素在内的基于发病机制的有针对性的细胞因子疗法促进了细胞因子失衡的消除并改善了患者的治疗效果。