Berezhnoy K. Local immunity characteristics as criteria of prognosis and immunorehabilitation of patients after operation on peritoneal cavity organs.

The thesis represents the study of local and system immunological responses in patients after the surgery on peritoneal cavity organs with the aim of substantiating the possibility of immunorehabilitation. On the basis of the data obtained, the significant changes in the local immunity in the various forms of the postoperative course of peritonitis such as serous fibrinous and purulenr fibrinous have been observed. In particular, in the purulent-fibrinous peritonitis, the neutrophile count increases and peritoneal macrophage count decreases as compared with the serous-fibrinous peritonitis, at the same time HLA-DR expression, CD3+T-lymphocyte count increase while the functional activity of the phagocytic cells decreases. The specific changes of the local immunity reflect the clinical features of the postoperative course in patients with peritonitis. Meanwhile, in system immunity, CD3+T-lymphocyte count decreases in the purulent-fibrinous peritonitis as compared with serous fibrinous peritonitis. CD19 cells and phagocytic activity also decrease. The comparison of local and system immunological response demonstrate that the changes in the local immunity are more informative appearing earlier and being more pronounced. For the first time, local immunotherapy with polyoxidonium was used in treatment of the purulent fibrinous peritonitis and the special scheme of such a treatment was elaborated. The local polyoxidonium treatment proved to be clinically successful providing for the advantageous immunomodulatory effect.