Dynamics of Some Cytochemical Parameters of Peripheral Blood Cells in Patients With Critical Ischemia of The Lower Extremities During Revascularizing Osteotrepanation With Intramedullary Laser Irradia

Hasanov IA¹, Kosayev JV²*, Abushov NS², Namazov IL², Sadikhov FG², Quliyev RA², Ibrahimova GR², Budagov IK^2
1Azerbaijan State Institute for Advanced Training of Doctors named after A. Aliyev, Baku, Azerbaijan
²Scientific Center of Surgery named after Acad. M.A. Topchubasheva, Baku, Azerbaijan
*Corresponding Author: Kosayev JV, Scientific Center of Surgery named after Acad. M.A. Topchubasheva, Baku, Azerbaijan.

Published: September 27, 2023

DOI: 10.55162/MCMS.05.167

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Abstract  

Objective: To study the dynamics of the cytochemical amount of some metabolic parameters in the formed elements of peripheral blood in patients with critical ischemia of the lower extremities (CILE) with revascularizing osteotrepanation with intramedullary laser irradiation (ROT with IMLI) using intravenous laser irradiation of blood (ILIB) and cytokine therapy (CT) in the perioperative period. Materials and methods: A prospective controlled clinical trial was conducted in 65 patients with CILE against the background of distal steno-occlusion of the arteries who underwent indirect revascularization operations. In the perioperative period, 34 patients underwent standard treatment (control group), 31 patients with ROT with IMLI – standard treatment + ILIB + CT (main group). In dynamics, upon admission to the clinic and upon completion of inpatient treatment, the cytochemical amount of glycogen (G), ribonucleoproteins (RNP), adenosine triphosphate (ATF) and the cytochemical activity of adenosine triphosphatase (ATF-ase) in the formed elements of peripheral blood were studied. The studied indicators of metabolic status were compared with identical parameters of 48 practically healthy individuals ("reference group"). Results: Upon admission to the clinic in patients with CILE with distal steno-occlusion, a sharp significant decrease in the cytochemical amount of G, RNP, ATF and ATF-ase in the formed elements of peripheral blood was revealed. Inclusion of ILIB and CT in the complex of therapeutic measures in the perioperative period during the operation of ROT with IMLI. in indirect revascularization, it led to an increase in G and RNP and a significant leveling of the cytochemical amount of ATF (t = 2.55, p = 0.013) and cytochemical activity of ATF-ase (t = 2.33, p = 0.014). Conclusion: The use of ILIB and CT together with standard treatment in the perioperative period in ROT with IMLI in comparison with the control group significantly corrects the metabolic status of peripheral blood cells in patients with CILE with distal steno-occlusion of the arteries. However, in the formed elements of the peripheral blood of patients with CILE, metabolic substrates (G, RNP, ATF and ATF-ase) are not fully restored. The dynamics of these indicators can be used as an objective criterion for evaluating the effectiveness of the therapy.

Keywords: critical ischemia of the lower extremities; indirect revascularization; intravenous laser irradiation of blood; cytokine therapy; metabolic status of peripheral blood cells

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