Patients with purulent-inflammatory diseases of soft tissues on the background of diabetes type 2 are resistant changes in various parts of the immune system. Hyperglycemia, hyperlipidemia, insulin resistance and adaptive hyperinsulinemia affect the cells of the immune system, promote the development of metabolic immunosuppression with the formation of stable immune dysfunction. The purpose of the study to investigate and analyze the metabolic state of immunocompetent cells in patients with purulent-inflammatory diseases of soft tissues on the background of DMD type 2. The study was conducted in 47 patients (the main group) with purulent-inflammatory diseases of soft-tissue on the background of diabetes mellitus, and 20 healthy volunteers (the comparison group) using the cytohistochemical restoration method of NST based on the percentage composition of neutrophils that have cytoplasm of formazan granules. The spontaneous neutrophil response was studied, as well as the parameters of the NST-test in stimulation of neutrophil granulocytes in vitro to assess the bactericidal, resource potential and their ability to complete phagocytosis. Results of the study showed that the decrease in the activity of myeloperoxidase and the NST-test in the conditions of stimulation of neutrophil granulocytes is a sign of unsatisfactory state of the bactericidal system of cells, which may be the cause of acute inflammatory processes in the body that accompany type 2 diabetes, which leads to functional exhaustion of the macrophage level of the immune body protection. At GZZMT against the background of DM 2 type compared with the norm, the “spontaneous” NST-test of neutrophils is high, which is due to the presence of inflammatory process. The index of stimulation of neutrophils is lower in the main group (1.6 times: 5.3±0.2% in the main group versus 8.4±0.4% in the control, p≤0.05), which is an indicator of a relatively weaker stimulation of those populations of neutrophils that were responsible for high indices in the “spontaneous” NST test, and the impaired state of cellular metabolism. So, in patients with type 2 diabetes, a violation of the bactericidal system of organism protection, which is one of the causes of the development of infectious and inflammatory processes.
Хірургічні ускладнення цукрового діабету (ЦД) 2-го типу, а саме гнійно-запальні захворювання м'яких тканин (ГЗЗМТ), є найбільш поширеними патологічними станами гнійно-септичної хірургії. Незадовільні результати лікування (тривалість лікування, рецидиви та прогресування гнійного процесу) вимагають подальших досліджень патофізіологічних і патоморфологічних механізмів гальмування систем захисту у цієї категорії хворих. Ви-вчення закономірних реакцій клітинного імунітету при ЦД 2-го типу є одним з імовірних напрямків вирішення цієї проблеми. Діагностика порушень імунної системи при різних патологічних станах базується на вивченні показників системного імунітету, а саме функціонального стану фагоцитуючих клітин (моноцитів і нейтрофілів) (Луніна Н.
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