Gramatiuk Svetlana Mykolayivna, Bagmut Irina Yurievna, Ivanova Julia Viktorivna, Tymchenko Mykhailo Yevhenovych, Kryvorotko Igor Vadimovich, Pak Svetlana Oleksyiyivna, Sheremet Michael Ivanovich
Department of Clinical Research, Ukraine Association of Biobank, Kharkiv, Ukraine.
Department of Clinical Pathophysiology, Topographic Anatomy and Operative Surgery, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine.
J Med Life. 2020 Jul-Sep;13(3):371-377. doi: 10.25122/jml-2020-0083.
The study of the incidence of cryoglobulinemia is relevant in patients with an intestinal anastomotic leak. This study aims to determine a laboratory marker of the risk of small intestine anastomotic leak. The study was based on 96 patients who were subjected to resections of segments of the small intestine with the formation of intestinal anastomoses at the State Institution "Zaytsev V.T. Institute of General and Urgent Surgery of National Academy of Medical Sciences of Ukraine". Of all the operated patients, there were 55.2% women and 44.8% men. Of the 96 patients examined, cryoglobulinemia was detected in the majority - 62.5% of patients, of which 4 were later proved to have inactive hepatitis C; the remaining 38.5% had no cryoglobulinemia. According to the existing theory of the autoimmune mechanism of postoperative surgical complications formation, the revealed decrease in the level of cryoglobulins on the second day could be related to their fixation in the microcirculatory bed and the development of immunocomplex inflammation. While the increase in the content of cryoglobulins in serum on the third day can be caused by their entry into the circulatory bed from deposition or fixation sites and the development of a secondary immune response. In patients with intestinal anastomosis failure after resection of intestinal segments, cryoglobulinemia rates increased more than 80 mg/l; this indicator could be used as a marker of postoperative complications.
对于存在肠吻合口漏的患者，研究冷球蛋白血症的发病率具有重要意义。本研究旨在确定小肠吻合口漏风险的实验室标志物。该研究以乌克兰国家医学科学院扎伊采夫V.T.普通与急诊外科学研究所的96例接受小肠段切除并形成肠吻合术的患者为基础。在所有接受手术的患者中，女性占55.2%，男性占44.8%。在96例接受检查的患者中，大多数患者（62.5%）检测出冷球蛋白血症，其中4例后来被证实患有非活动性丙型肝炎；其余38.5%的患者没有冷球蛋白血症。根据术后手术并发症形成的自身免疫机制的现有理论，术后第二天冷球蛋白水平的下降可能与其在微循环床中的固定以及免疫复合物炎症的发展有关。而第三天血清中冷球蛋白含量的增加可能是由于它们从沉积或固定部位进入循环床以及继发免疫反应的发展所致。在肠段切除术后出现肠吻合口失败的患者中，冷球蛋白血症率升高超过80mg/l；该指标可作为术后并发症的标志物。
