Sulaeva O. Pathogenesis of aqute bleeding from ulcers of gastroduodenal zone

Object of investigation - mechanisms of gastroduodenal ulcer bleeding; aim - to determine informative criteria of diagnostics and prediction of acute gastroduodenal bleeding based on the analysis of mechanisms of hemostasis disorders, inflammation and ulcer repair dependently on reactivity of organism; methods - biochemical, morphological, immunohstochemical, cytochemical, statistical; newness and results - it has been proved that platelets (Pl), neutrophils (Nph) and monocytes (Mc) of peripheral blood are representative as a model for diagnostics of reactivity and prediction of ulcer bleeding outcome; structural and pathochemical determinants of in-sufficient haemostasis, including reduction of Pl response to thrombin and ADP with hypoadrenoreactivity and hyposensitivity to serotonin, in patients with acute ulcer bleeding has been established; it has been proved that dysfunction of Mc and Nph is a risk factor of disorders of ulcers reparation; the increase of Nph recruitment to marginal zone of ulcers and disorders, accompanied with changes of their functional activity and regulation have been occurred; the elevation of basal activity of inducible nitric oxide synthase (iNOS) in Mc under bleeding and hyperergic rection of macrophages associated with microcirculatoty disturbance, violation of mechanisms limiting acute inflammatory infiltration and changes of cooperation between leukocytes, myofibroblasts, endothelium and the covering epithelium cells have been shown; the criteria predicting the outcome of bleeding and repair, including aggregation of Pl induced by thrombin and ADP, index of the functional reserve of iNOS activity and Nph response to histamine have been determined; introduced - in practice of Institute of urgent and recovery medicine surgery NAMS of Ukraine (Donetsk), Institute of traumatology and orthopedics of Donetsk National Medical University, and in educational process at departments of pathophysiology of medical universities in Donetsk, Crym, Zaporozhe, Lugansk, and Bukovina; at the department of histology, cytology and embryology of A. A. Bogomoletz National medical university (Kyiv); scope of use - scientific and educational processes at departments of pathophysiology at the Highest Schools of Medicine, diagnostic and medical process of surgical and therapeutic departments.