[Status of the kallikrein-kinin systems and level of antiproteinase potential during postoperative treatment of various forms of peritonitis]. / Sostoianie kallikrein-kininovoi sistemy i uroven' antiproteinaznogo potentsiala pri posleoperatsionnom lechenii razlichnykh form peritonita.

Some parameters of the kallikrein-kinin system and the antiproteinase potential were studied in patients with diffuse peritonitis during the routine treatment course, after additional intramuscular administration of mexidol (inhibitor of free radical oxidation with antiproteinase activity) as well as after treatment of the patients with physiological solution containing ozone (4-7 mg/l used as a donor of free radicals), which was applied for washing of abdominal cavity in one group of patients during surgical operation and for intravenous administration in the other group. The kallikreinkinin system parameters were distinctly altered in the patients with peritonitis and the rate of the system activation correlated with the disease severity. Content of the alpha 1-inhibitor of proteinases (alpha 1-PI) was increased by the middle period of the treatment course and decreased as the inflammation lowered. alpha 2-Macroglobulin (alpha 2-MG) was altered less distinctly as compared with alpha 1-PI. Patterns of the antiproteinase potential in blood plasma (alpha 1-PI and alpha 2-MG) may be used for diagnostic and prognostic purposes in post-surgical treatment of patients with diffuse peritonitis; a decrease in the potential value proved to be a symptom of danger. Both mexidole and ozone exhibited positive clinical effect in treatment of the disease. Although these drugs had an opposing effect on the proteinases activity, their similar action on the antiproteinase potential appears to be responsible for the medicinal efficiency. Clinical effect of the drugs may be arranged as follows: mexidole, ozone administered intravenously and ozone used for intraabdominal washing.