Shyian S. Clinical and biochemical study of antioxidant therapy in patients with polypsis rhinosinusitis

The thesis is devoted to clarification of the antioxidant drugs role in complex treatment efficiency improvement of patients with chronic nasal polyposis (NP) by stabilizing pro-/antioxidant disturbance. The nasal tissue histopathological features and biochemical changes in lipid peroxidation processes and antioxidant defense in peripheral blood are characterized in depend on the diagnosis type and different stages of conservative treatment during 12 month’s term after surgical measure. It is first shown, that lypoperoxidation disturbances and low-molecular, enzymatic and extracellular systems of antioxidant (AO)-defense compensator efficiency breach in polypoid tissue and peripheral blood of NP patients depend on the citohistological type of polyps. It is fond, that in 89.8 % patients the clinical signs of NP associate with its eosinophilic infiltration, that complicated with elevation of carbonyl lipid fraction, erythrocytic catalase (E-CAT) enzymatic activity and АО protection decrease in blood against norm rate and increase 4-hydroxinonenal (4-HNE) level, erythrocytic superoxide dismutase (Zn/CuSOD) and E-CAT activity and factor of AO-defense in nasal polyps in compare to hypertrophic nasal epithelium. It is revealed, that decrease levels of AO-protection, which associates with increased activity of Zn/CuSOD on a ground of blood erythrocytic glutathione decrease level, thiobarbituric acid reactive substances (TBA-RS) accumulation in combination with elevated content of ceruloplasmin in 15.9 % patients on 27–30 days after polypectomy precede the NP clinical signs recurrence on 12-month. Additional course of the AO in the treatment patients after polypectomy on 12 month helps to stabilize the lipid carbonyl pool to physiological level and restore the glutathione content, E-CAT activity and level of AO-defense capacity in blood, that improve therapeutic efficacy of intranasal steroid spray and reduces the likelihood of NP recurrence on 20 %. Obtained results can be used in medical practice for optimization of clinico-diagnostic and therapeutic approaches in treatment of patients with NP, that associates with activation of free radical oxidation.