Vlasov A P, Bolotskikh V A, Vlasova T I, Sheyranov N S, Vasil'ev V V, Sinyavina K M, Bolushev P O
National Research Mordovia State University. N.P. Ogarev, Saransk, Russia.
Voronezh State Medical University named after N.N. Burdenko,Voronezh, Russia.
Khirurgiia (Mosk). 2019(6):73-79. doi: 10.17116/hirurgia201906173.
The purpose of the study is to establish the effectiveness of remaxol in the correction of endogenous intoxication in patients with acute peritonitis.
The work is based on the results of clinical and laboratory studies. The clinic examined 55 patients with acute moderate peritonitis as complication of various diseases (acute appendicitis, perforated gastric or duodenal ulcer, acute intestinal obstruction, acute destructive cholecystitis). Before surgical operation and in the early postoperative period we evaluated the severity of endogenous intoxication by the level of hydrophilic and hydrophobic toxic products. The content of molecular products of lipids peroxidation - oxidative stress, phospholipase activity were determined in the blood plasma. In the study group (n = 28) in the postoperative therapy additionally included remaxol (400 ml intravenous fluids).
Research established that the occurrence of endogenous intoxication syndrome in patients with acute peritonitis associated with the activation of oxidative stress and phospholipases, high intensity of which is maintained even after elimination of the source of peritonitis with manifestation on the 1st day after surgery. Remaxol include leads to a significant reduction in the severity of intoxication syndrome in patients with acute peritonitis. Positive effect of the drug on the correction of endogenous intoxication is largely determined by its ability to significantly reduce oxidative stress and the activity of phospholipases, as the most important membrane destabilizing agents. The greatest detoxication effect of the drug is recorded when it is applied already at the preoperative stage of patients when its ability to reduce the activity of trigger agents of catabolic processes implemented to the greatest extent.
In acute moderate peritonitis, remaxol use before surgery or in the early postoperative period in complex therapy leads to a significant correction of factors contributing to the development and preservation of the intensification of catabolic processes - one of the sources of endogenous intoxication.
本研究的目的是确定瑞马索（remaxol）在纠正急性腹膜炎患者内源性中毒方面的有效性。
本研究基于临床和实验室研究结果。该诊所检查了55例因各种疾病（急性阑尾炎、胃或十二指肠溃疡穿孔、急性肠梗阻、急性坏疽性胆囊炎）并发急性中度腹膜炎的患者。在手术前和术后早期，我们通过亲水性和疏水性毒性产物水平评估内源性中毒的严重程度。测定血浆中脂质过氧化分子产物的含量——氧化应激、磷脂酶活性。研究组（n = 28）在术后治疗中额外使用了瑞马索（400毫升静脉输液）。
研究表明，急性腹膜炎患者内源性中毒综合征的发生与氧化应激和磷脂酶的激活有关，即使在消除腹膜炎来源后，其高强度仍持续存在，并在术后第1天表现出来。使用瑞马索可显著降低急性腹膜炎患者中毒综合征的严重程度。该药物对纠正内源性中毒的积极作用在很大程度上取决于其显著降低氧化应激和磷脂酶活性的能力，因为它们是最重要的膜不稳定剂。当在患者术前阶段就使用该药物时，记录到其最大的解毒效果，此时它降低分解代谢过程触发剂活性的能力得到最大程度发挥。
在急性中度腹膜炎中，术前或术后早期在综合治疗中使用瑞马索可显著纠正导致分解代谢过程强化（内源性中毒的来源之一）发展和持续的因素。
