ОСОБЕННОСТИ ВЛИЯНИЯ АКТИВНОСТИ ВНУТРИКЛЕТОЧНЫХ ФЕРМЕНТОВ НА СОСТОЯНИЕ РЕСПИРАТОРНОГО ВЗРЫВА НЕЙТРОФИЛОВ ПРИ ПОСЛЕДУЮЩЕМ РАЗВИТИИ СЕПСИСА У БОЛЬНЫХ РАСПРОСТРАНЕННЫМ ГНОЙНЫМ ПЕРИТОНИТОМ

The purpose of the research was to study the features of the respiratory burst activity and NAD(P)-dependent dehydrogenases activities in blood neutrophils in the forecast of the development of abdominal sepsis in patients with widespread purulent peritonitis (WPP). The study involved 50 patients with WPP in the preoperative period. Abdominal sepsis was developed by 35 patients (70.0%) from 5 to 10 days postoperative period, 15 patients (30.0%) hadn’t complications. The respiratory burst condition of blood neutrophils was examined using a chemiluminescent assay. Intracellular activity of the NAD(P)-dependent dehydrogenases was researched with using bioluminescent methods. It was found that patients with WPP whose dynamics of the preoperative period will develop sepsis the chemiluminescent activity of blood neutrophils was characterized by a reduced level of spontaneous synthesis of the primary reactive oxygen species (ROS) and elevated levels of spontaneous synthesis of secondary ROS relative of the indicators identified in patients without subsequent complications. The feature of neutrophil metabolism in WPP patients without subsequent development of sepsis was high activity of the anaerobic lactate dehydrogenase reaction and decrease in activity of the NADP-dependent decarboxylating malate dehydrogenase. In patients with WPP and the subsequent development of sepsis was found high level of NAD-dependent substrates outflow citric acid cycle in the reaction of amino acid metabolism via glutamate dehydrogenase that may affect the activity of aerobic respiration in the neutrophils. Using correlation analysis was found that the intensity of the neutrophils respiratory burst in patients with no subsequent complications depends on the activity of anaerobic glycolysis. Patients with subsequent development of sepsis in the blood neutrophils were detected competitive relationship between the levels of primary and secondary ROS synthesis and enzyme activity.