Moroz P. Features of development, course and treatment of patients with acute peritonitis with different variants of modification of IL-1β gene (-511C/T)

Object - patients with different forms of acute peritonitis;the aim is to increase the efficiency of treatment of patients with acute peritonitis by studying genetically determined mechanisms for its progression, developing prognostic criteria for the course and objectivization of indications for a differentiated choice of therapeutic tactics; The methods are clinical, biochemical (the intensity of peroxideoxidation and activity of enzymes of antioxidant defense, fibrinolytic and proteolytic activity of blood plasma), immuneenzyme (level of interleukin 1β), instrumental (X-ray, ultrasound, ЕGDS, CT), genetic (determination of polymorphism of the IL- 1β -511C/T), statistical; results - for the first time, the mechanisms of development and progression of various forms of acute peritonitis have been investigated depending on plasma concentration of interleukin 1β; the dependence of its level in blood plasma on the variants of the IL-1β gene (-511С/T) was established - the lowest concentration was detected in the SS-variant, the highest - in patients with the TT variant; the association of the IL-1β (-511С/T) gene with the development of various forms of acute peritonitis has been proved for the first time; it was established that in the isolated peritonitis the SS-variant of the genotype prevail sand the insignificant growth of concentration in plasma of blood IL-1β is characteristic for it; when sputum and, especially, general peritonitis, an increase in the frequency of detection of СT and TT variants is observed with a corresponding increase in the plasma concentration of this cytokine in the blood plasma; new regularities of the pathogenesis of the inflammatory process in the peritoneal cavity are revealed, the significance in the seprocesses of the imbalance of the hemostasis system, unrestricted proteolysis, disturbance of equilibrium in the redox system and their association with variants of the IL-1β gene (-511C/T) are shown; it is proved that more pronounced changes in the indicated systems are observed in the СT and TT variants of the genotype; the algorithm of prediction of the course of peritonitis based on the results of geneticresearch; It is proved that according to CT and TT variants there is a high probability of progression of the inflammatory process in the peritoneal cavity and the development of purulent-septic complications; scientifically substantiated medical tactics in patients with common forms of peritonitis, new and improved existing methods of surgical intervention have been developed.