Kravchenko A. Mechanisms of lithotripsy complications in patients with urolithiasis

The thesis is devoted to solving actual scientific task of modern pathophysiology - the mechanisms of platelet (PLT) and leukocyte (WBC) dysfunction in urolithiasis, and complications of lithotripsy (LT). Analysis of the functional state of PLT and WBC was conducted in 145 patients with chronic obstructive pyelonephritis (COPN). Gender and age characteristics of leukocytes reactions were identified during relapse phase of COPN which allow a differentiated approach to the interpretation of clinical and laboratory parameters. Blood cells interaction depends on stimulation of platelets by agonists, which determine the composition of platelet-leukocyte aggregates during remission and relapse phases of COPN. The observed phenomenon of PLT hyporeactivity in patients with COPN causes inflammation and thrombogenesis disorders. Joint action of subthreshold doses of epinephrine and ADP, and epinephrine and FAT potentiates (p<0.05) PLT functional activity, indicating preservation of their adaptation mechanisms. Severity of hematuria after LT in case of PLT hyporeactivity is associated with inflammation, localization and size of calculus and is limited by adaptive PLT capacities. Features of platelet response 24 h after LT are due to ?2-adrenoreceptor and purine receptors sensitivity, and reflect the individual reactivity. Epinephrine and ADP interaction in the modulation of PLT function allows to specify the possible patterns of thrombogenesis regulation after LT.