[The efficacy of recombinant interleukin-1ß in surgical treatment of acute ulcerative gastroduodenal bleedings.]

There was reported the results of the use of recombinant interleukin-1ß in basic conservative measures in the surgical treatment of acute gastroduodenal ulcer bleeding. Gastric ulcer were in 20 patients, duodenal ulcer in 84 patients and combined ulcers in 16 patients. According to А.А. Шалимов hospitalized patients with mild blood loss were 27, moderate degree - 62 and severe degree - 31 patients. According to J. Forrest, 29 showed active bleeding (F Ia, F Ib), in 67 - unstable hemostasis (F IIa, F IIb, F IIc) and in 24 - F III. Within the framework of differentiated individual-active tactics, patients were operated in emergency (21), urgent (38), delayed (35), and 26 people underwent early planned operations. Patients in the main group (63) after the operation, was included recombinant interleukin-1ß to the basic therapeutic measures additionally, taking into account the degree of blood loss and immune disorders. Patients of comparison group (57) before and after surgery received standard basic therapy without immunocorrection. In a comparative aspect, it has been proved that in postoperative period on the background of standard conservative measures, the use of recombinant interleukin-1ß positively influences elimination of the secondary immunodeficiency and cytokine imbalance significantly improves the results of surgical treatment.

[State of immune and cytokine status in acute ulcerative gastroduodenal bleeding].

The paper analyzes the results of a survey of 37 patients with acute ulcerative gastroduodenal hemorrhage. During endoscopy found that 7 patients the cause of bleeding was gastric ulcer, duodenal ulcer in 27 and 3 concomitant ulcer. Hemostasis was evaluated by J. Forrest and the severity of blood loss was assessed by the A.A. Shalimov: with blood loss was mild in 11 patients, the average degree--12 and with severe--14. In all patients on admission in the peripheral blood were studied state of cellular, humoral and cytokine profile: CD3+, CD4+, CD8+, CD4+/CD8 + and CD19+, FI, FF, CEC, IgA, M, G, TNF-α, IFN-γ, IL-1, IL-2, IL-4, IL-6, IL-8 and IL-10. In general patients with on admission revealed significant changes in the immune and cytokine status. In cellular immunity occurs immunosuppression. Disturbances in humoral immunity manifests itself in increased levels of lymphocytes in blood loss and hardships of all multi-directional changes in the concentration of immunoglobulins depending on the amount of blood loss. When there is an imbalance in cytokine status, the depth of which depends on the degree of blood loss.