spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.38181/2223-2427-2021-1-30-38spractice-204Research ArticleСтатьиРОЛЬ МАРКЕРОВ СИСТЕМНОГО ВОСПАЛИТЕЛЬНОГО ОТВЕТА В ПОСЛЕОПЕРАЦИОННОМ ПЕРИОДЕ. ОБЗОРTHE ROLE OF MARKERS OF SYSTEMIC INFLAMMATORY RESPONSE IN THE POSTOPERATIVE PERIOD. REVIEWhttps://orcid.org/0000-0003-2631-7631КубышкинВ. А.KubyshkinV. A.

Кубышкин Валерий Алексеевич – д.м.н., академик РАН, заведующий кафедрой хирургических болезней

119991, г. Москва, ул. Ленинские Горы, д. 1

Kubyshkin Valeriy Alekseevich – MD, Academician of the Russian Academy of Sciences, Head of the Department of Surgical Diseases 

119991, Moscow, 1 Leninskie Gory

https://orcid.org/0000-0001-6734-3989СамоходскаяЛ. М.SamokhodskayaL. M.

Самоходская Лариса Михайловна – к.м.н., доцент, заведующая отделом лабораторной диагностики

119991, г. Москва, ул. Ленинские Горы, д. 1

119192, г. Москва, Ломоносовский проспект, д. 27, к. 10

Samokhodskaya Larisa Mikhaylovna – Candidate of Medical Sciences, Associate Professor, Head of the Department of Laboratory Diagnostics  

119991, Moscow, 1 Leninskie Gory

119192, Moscow, 27 – 10 Lomonosovsky Prospekt

https://orcid.org/0000-0002-8790-8040КоролевЮ. М.KorolevYu. M.

Королев Юрий Михайлович – студент

119991, г. Москва, ул. Ленинские Горы, д. 1

119192, Москва, Ломоносовский проспект, д. 27, к. 1

+7(962)9054431 

Korolev Yuriy Mikhaylovich – student  

119991, Moscow, 1 Leninskie Gory

119192, Moscow, 27 – 1 Lomonosovsky Prospekt

+7 (962) 9054431 

korolyov-1997@mail.ruМосковский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины (МГУ имени М.В. Ломоносова)РоссияFederal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Faculty of Medicine (Lomonosov MSU)Russian FederationМосковский государственный университет имени М.В. Ломоносова, факультет фундаментальной медицины (МГУ имени М.В. Ломоносова); Медицинский научно-образовательный центр МГУ имени М.В. ЛомоносоваРоссияFederal State Budget Educational Institution of Higher Education M.V. Lomonosov Moscow State University, Faculty of Medicine (Lomonosov MSU); Medical Scientific Educational Centre, Lomonosov Moscow State UniversityRussian Federation202119042021013038Copyright © Кубышкин В.А., Самоходская Л.М., Королев Ю.М., 20212021Кубышкин В.А., Самоходская Л.М., Королев Ю.М.Kubyshkin V.A., Samokhodskaya L.M., Korolev Y.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/204

Несмотря на все достижения современной хирургии количество послеоперационных инфекционных осложнений в мире остается высоким. Их возникновение приводит к удлинению периода госпитализации пациентов, требует применения дополнительных лечебно-диагностических мероприятий, что в конечном итоге ведет к повышению затрат на лечение и значительным финансовым потерям в системе здравоохранения. Поэтому важно выявлять послеоперационные осложнения на ранней стадии, еще до развития выраженных клинических симптомов, предсказывать их возможное развитие у определенной категории пациентов. Для этих целей ученые пытаются использовать различные лабораторные маркеры. В данной работе мы проанализировали как широко известные показатели воспалительного ответа, а именно: С-реактивный белок, альбумин, их соотношение, прокальцитонин и интерлейкин-6, так и относительно новые параметры, которые коллективы исследователей пытаются применить для этих целей: показатели гранулярности и реактивности нейтрофилов, панкреатический каменный белок и панкреатит-ассоциированный белок. Мы постарались собрать наиболее полную информацию, существующую на данный момент, оценить мнения исследователей, выявить противоречия в их работах и попытаться объяснить их причину. В результате оказалось, что даже известные в течение многих лет маркеры воспаления не являются абсолютно специфичными в отношении послеоперационных инфекционных осложнений. Мы пришли к выводу, что большинство из описанных нами лабораторных параметров может быть в той или иной мере использовано в ранней диагностике послеоперационных инфекционных осложнений, однако для получения более полной информации в этой области знаний необходимо проведение новых крупных исследований.

Despite all the achievements of modern surgery, the number of postoperative infectious complications in the world remains high. Their occurrence leads to a longer period of patients’ hospitalization, requires the use of additional medical and diagnostic measures, which ultimately leads to higher treatment costs and significant financial losses in the health care system. Therefore, it is important to identify postoperative complications at an early stage, even before the development of pronounced clinical symptoms, and to predict their possible development in a certain category of patients. For these purposes, scientists try to use various laboratory markers. In this paper, we analyzed both well-known indicators of the inflammatory response, such as: C-reactive protein, albumin, their ratio, procalcitonin and interleukin-6, and relatively new parameters that research teams are trying to apply for these purposes: neutrophil granularity intensity and neutrophil reactivity intensity, pancreatic stone protein and pancreatitis-associated protein. We tried to collect the most complete information available at the moment, evaluate the opinions of researchers, identify contradictions in their works and try to explain their cause. As a result, it turned out that even the markers of inflammation known for many years are not absolutely specific for postoperative infectious complications. We concluded that most of the laboratory parameters described in this article can be used to some extent in the early diagnosis of postoperative infectious complications, but if we want to obtain more complete information in this area of knowledge, it is necessary to conduct new largescale studies.

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The authors declare that there are no conflicts of interest present.