Objective. To study the systemic inflammatory reactions peculiarities in patients with non-specific purulent-inflammatory spinal diseases (NSPISD).
Materials and methods. Fifty NSPISD patients were examined. The comparison group consisted of 30 healthy volunteers (HVs). The NSPISD patients were divided into 2 subgroups: subgroup 1 consisted of the patients (n=20) the pathological process localized within the body of the vertebra and/or the intervertebral disc, subgroup 2 — of those (n=30) having local purulent complications. The general, biochemical blood tests values, hemostasiograms, neutrophilic lymphocyte indices (NLI), leukocyte intoxication indices (LII), hematological intoxication indices (HII) were studied. Systemic inflammatory response syndrome (SIRS) and sepsis were diagnosed according to the Sepsis-3 concept.
Results. The subgroup 1 patients had the leukocytes, erythrocytes, and blood albumin levels within the normal limits. The subgroup 2 patients demonstrated evident leukocytosis, anemia and decreased blood albumin development. The differences were statistically significant (P<0.05). The albumin/globulin and albumin/fibrinogen ratios were found to decrease the decrease being most pronounced in the subgroup 2 patients (P<0.05). The NLI, LII, and HII values in the subgroup 2 patients were statistically significantly higher than in the HVs and the subgroup 1 patients. The disease course was complicated by SIRS in one (5%) of the subgroup 1 patients while in subgroup 2, SIRS was noted in 12 (40%) subjects and sepsis in 9 (30%) patients. The NLI and LII values in septic patients were statistically significantly higher than in the patients with SIRS and HVs (P<0.05). The HII values of patients with SIRS and sepsis were higher than those of HVs (P<0.05) but did not differ statistically significantly (P=0.28).
Conclusion. Prediction of local purulent complications in NSPISD patients allows change significantly the tactics of this pathology surgical treatment and improve the outcomes by applying the earliest possible surgical interventions.Ключевые слова:
Автор(ы): V. I. Petukhov, K. M. Kubrakov, A. V. Kornilov, M. V. Kuntsevich, S. N. Ermashkevich