Journal of Biomedicine and Practice – Biomeditsina va amaliyot jurnali 10-jild 5-son (2025)
PERSONALIZED ALGORITHM FOR IMMUNOCORRECTION IN PATIENTS WITH GENERALIZED PERITONITIS AND HIGH IMMUNOLOGICAL RISK
РАХИМОВ Ойбек Умарович, ХАМДАМОВ Бахтиер Зарифович, ДАДАЕВ Ширин Аманович
Annotatsiya
Background. Generalized peritonitis is associated with a high rate of adverse outcomes; empirical immunocorrection without risk stratification limits clinical effectiveness. A reproducible algorithm is needed to link the clinical–immunological profile to the intensity of immunomodulation. Aim. To clinically substantiate a personalized immunocorrection algorithm for patients with generalized peritonitis at high or critical immunological risk. Materials and Methods. Single-center prospective study (n = 60). On postoperative day 1, immunological stratification (CD4⁺, NK, IgM, circulating immune complexes [CIC], IL-6/IL-10) assigned patients to low, high, or critical risk; the present analysis focused on the high- and critical-risk groups. The algorithm specified basic or extended immunocorrection with checkpoints on days 3 and 7, allowing escalation/de-escalation. Statistical analysis used non-parametric tests and descriptive analytics. Results. Stratification yielded: low — 18 (30.0%), high — 26 (43.3%), critical — 16 (26.7%). Therapeutic routing was guided by clinical–immunological indicators and aligned with the initial clinical phase: in the critical-risk group, the terminal phase predominated and the reactive phase was absent; in the high-risk group, the toxic phase predominated. The algorithm proved operationally manageable owing to predefined checkpoints and escalation criteria. Conclusion. The personalized algorithm enables standardized, profile-driven decision-making on immunocorrection and improves treatment controllability. Before integration into clinical protocols, multicenter validation, harmonization of escalation/de-escalation thresholds, and formalization of risk-category calculation rules are required.
распространённый перитонит, иммунологический риск, персонализированная иммунокоррекция, цитокиновый профиль, клинический алгоритмgeneralized peritonitis, immunological risk, personalized immunocorrection, cytokine profile, clinical algorithmtarqalgan peritonit, immunologik xavf, shaxsiylashtirilgan immunokorreksiya, sitokin profili, klinik algoritm
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