Kashchak T. Pathogenetic characteristics of hepatic dysfunction in the late period of orthopaedic trauma, complicated with burn

In the thesis paper pathogenetic characteristics of hepatic injury in the period of late manifestations of traumatic disease (14-28 days) after the application of orthopaedic trauma, complicated with burn were found, and the effectiveness of tiotriazolini use for reducing manifestations of hepatic dysfunction have been proved. It was shown that in the period of late manifestations of traumatic disease under conditions of the mechanic and thermal polytrauma simulation the processes of lipid peroxidation and cytolysis phenomena do not abate in liver, antioxidant protection is reduced. Phenomena of dyscytokinogenesis with increase of tumour necrotic factor-α content after 21 days, interleukin-4 and monocyte chemoattractant protein content throughout the experiment and decrease of interferon-γ after 28 days and interleukin-1α from 14 to 28 days in blood serum are noted. Violation of the functional and morphological state of liver, which is manifested with a decrease in the rate of bile excretion, formation and excretion of its main components, dystrophic-necrotic changes in centrolobular hepatocytes throughout the experiment was found out. These violations are significantly higher under the polytrauma condition compared to the isolated orthopaedic trauma or burn. The use of tiotriazolini during 14 days of post-traumatic period has a positive effect on the course of the polytrauma, which is manifested with the im-provement of antioxidant protection and lipid peroxidation, decreased manifestations of cytolysis, improved indices of functional and morphological state of liver, changes in control of pro-inflammatory cytokines.