Stepas I. Hemostasis biochemical mechanisms and hepatocytes functioning in acute cholecystitis

The dissertation is devoted to the clarification of the features of the hemostasis system and the functioning of hepatocytes in the uncomplicated acute calculous cholecystitis and cholecystitis complicated by obstructive jaundice. The results of the performed studies showed that the development of acute calculous cholecystitis, in particular, complicated by obstructive jaundice, was accompanied by the violation of blood hemostatic parameters and biochemical markers of the hepatocytes functioning. In order to evaluate the activity of the inflammatory process, it has been proposed to calculate the inflammation activity index, which was found to be significantly higher in complicated acute calculous cholecystitis compared to uncomplicated, which may indicate a generalization of the pathological process and serve as a prognostic marker for the course of acute calculous cholecystitis. The revealed violations were reflected in the established correlation between the hemostatic system indicators and hepatocyte functioning. Changes in the structure, amount and strength of correlations, as well as the emergence of new bonds in acute calculous cholecystitis, complicated by obstructive jaundice, indicate the tension of the adaptive mechanisms of the hemostasis system and the functioning of hepatocytes. Based on the results of eight indicators, namely, the content of soluble fibrin-monomeric complexes, activity in the protein C system, total fibrinogen concentration, activated partial thromboplastin time, Hageman-dependent fibrinolysis, prothrombin time, international normalized ratio, and platelet number, a discriminant model was constructed, which made it possible to classify the patients under examination by diagnosis.