4 . 2019

Развитие окислительного стресса при острой ишемии нижних конечностей у лиц пожилого и старческого возраста

Abstract

The aim of the work is to to determine the relationship between the development of oxidative stress as a predictor of the course and outcome of the disease after performing revascularization in patients with acute lower limb ischemia.

Methods. Investigated the features of the course of acute ischemia of the lower limb in 44 patients aged 70 (60; 78) years. The comparison group consisted of healthy volunteers or patients with mild systemic disorders of the same age category. We studied the blood oxidative activity in all patients, the level of spontaneous and induced blood chemiluminescence was determined at admission for treatment in the vascular surgery department, before and after revascularization, at 3, 5, 7 and 10 days of therapy, the total antioxidant activity was simultaneously measured. Neutrophilic lymphocytic coefficient was calculated.

Results. In the course of the study, all patients with acute ischemia of the lower limb showed an increase in spontaneous and induced blood chemiluminescence, and a correlation was observed between these indicators depending on the degree of ischemia and the outcome of the disease. The restoration of the oxidative activity of blood cells and the antioxidant activity of blood plasma was associated with successful revascularization of the ischemic limb.

Conclusion. Acute limb ischemia and the reperfusion period are accompanied by pronounced cytolysis and increased ROS production, a decrease in the total antioxidant activity during the reperfusion period, which causes the development of oxidative stress. The clinical picture of acute limb ischemia in elderly and senile patients due to chronic arterial occlusion often has an asymptomatic course, while laboratory findings indicate the presence of massive cell death. An increase in the neutrophilic-lymphocytic coefficient above the critical values already upon admission of patients is a predictor of a lethal outcome. The criteria for a favorable outcome in this group of patients is the normalization of blood chemiluminescence, antioxidant activity.

Keywords:acute limb ischemia, oxidative and antioxidant activity, reactive oxygen species, reperfusion syndrome

For citation: Magamedov I.D., Pivovarova L.P., Ariskina O.B., Nokhrin S.P., Soroka V.V., Ryazanov A.N., Kurilov A.B., Magomedov S.B., Radjabov I.M., Gaipov M.M., Goncharova O.V. The development of oxidative stress in acute ischemia of the lower limbs in elder and senile patients. Clin Experiment Surg. Petrovsky J. 2019; 7 (4): 23–31. doi: 10.24411/2308-1198-2019- 14003 (in Russian)

Received 11.04.2019. Accepted 31.10.2019.

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