Klinik fanlar yilnomasi 2-том 4-нөмір (2025)
CLINICAL AND IMMUNOLOGICAL ASPECTS OF FORECASTING REPERFUSION INJURIES OF THE MYOCARDIUM DURING CARDIAC SURGERY
Умаров Бахтиёр Ятгарович, Сиддиқов Азизбек Мурод ўғли
Аңдатпа
Myocardial reperfusion damage (MRD) remains one of the main causes of the complicated course of the early postoperative period in patients who have undergone cardiac surgery with artificial circulation (CA). Despite the use of modern cardioprotective strategies, the frequency of pronounced reperfusion disorders reaches 25-40%, which is accompanied by an increased risk of arrhythmias, a decrease in myocardial contractile function, the need for inotropic support, and an increase in the length of stay in the intensive care unit. The aim of the study is to identify clinical and immunological markers that allow predicting the severity of RPM. The study included 120 patients operated on with IC. Before and after surgical intervention, the levels of IL-6, TNF-α, CRP, HMGB1, Fas/FasL, troponin I, and CK-MB were determined dynamically. An increase in IL-6 > 35 pg/ml and TNF-α > 30 pg/ml 6-12 hours after surgery is associated with a high frequency of complications (AUC = 0.82 and 0.79, respectively). The combination of IL-6 > 35 pg/ml + Fas > 120 pg/ml showed the highest prognostic accuracy (sensitivity 84%, specificity 76%). The obtained data confirm the significance of immunological markers in addition to standard biochemical tests and allow us to propose an algorithm for early prediction of RPM.
reperfusion, myocardium, cytokines, IL-6, TNF-α, Fas, artificial circulation, prognosis, immunology.реперфузия, миокард, цитокины, IL-6, TNF-α, Fas, искусственное кровообращение, прогнозирование, иммунология.реперфузия, миокард, цитокинлар, ИЛ-6, ТНФ-α, Фас, сунъий қон айланиши, прогнозлаш, иммунология.
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