CORRECTION OF PROOXIDANT-ANTIOXIDANT EQUILIBRIUM IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES AND A HIGH RISK OF DEVELOPMENT OF REPERFUSION-REOXIGENATION COMPLICATIONS

  • O. B. Kolotylo BUKOVINIAN STATE MEDICAL UNIVERSITY
Keywords: prooxidant-antioxidant system, reperfusion-reoxygenation complications, alpha-tocopherol, quercetin, free radical oxidation

Abstract

Introduction. Obliterating atherosclerosis of the main peripheral vessels accounts for more than 20 % of all cardiovascular pathologies, that is, more than 3 % of the total population. At the present stage, the problem of treating patients with terminal stages of occlusive diseases of the lower limb arteries – “critical ischemia”, which corresponds to 3–4 stages of chronic ischemia according to B.V. Pokrovskyi or III–IV by Fontaine classification, is becoming especially acute.

The aim of the study – to learn the possibility of correcting the prooxidant-antioxidant systems in patients with chronic critical lower limb ischemia and a high risk of reperfusion – reoxygenation complications after reconstructive operations.

Research Methods. The analysis is based on a comprehensive examination and surgical treatment of 220 patients with obliterating atherosclerosis of the aorta and major arteries of the lower extremities. The activity of the constituents of the prooxidant-antioxidant system was determined using spectrophotometric methods, the optical density was measured on a Biomat 5 spectrophotometer (UK).

Results and Discussion. In order to adjust the prooxidant-antioxidant balance, alpha-tocopherol and quercetin were prescribed in the preoperative period. The use of drugs allowed to stabilize the activity of the prooxidant-antioxidant system at the time of surgery. In particular, in the indicated period, the activity of free radical oxidation decreased, as evidenced by a decrease in 1.3 (p<0.05) times the content of active thiobarbituric acid products in blood serum. At the same time, a decrease of 1.5 (p<0.05) times in the blood serum superoxide dismutase was noted due to a slight increase in the catalase content and a constant content of ceruloplasmin. The results of the study confirm that revascularization of the lower extremities promotes the activation of the prooxidant-antioxidant system and, above all, an increase in the activity of free-radical oxidation.

 Conclusion. The use of alpha-tocopherol and quercetin in patients with a high risk of reperfusion-reoxygenation complications in the preoperative period helps to prevent significant disturbances in the development of endothelial dysfunction and impaired functioning of the microvasculature due to the increased ability of prooxidant-antioxidant balance.

References

Horobets, N.M. (2015). Novi stratehichni pidkhody do korektsii endotelialnoi dysfunktsii [New strategic approaches to the correction of endothelial dysfunction]. Liky Ukrainy – Medicines of Ukraine, 2, 20-24 [in Ukrainian].

Henyk, S.M., & Symchych, A.V. (2016). Reperfu­ziinyi syndrom pislia revaskuliaryzatsii ishemii nyzhnikh kin­tsivok [Reperfusion syndrome after lower limb ischemia revascularization]. Sertse i sudyny – Heart and Blood Vessels, 3, 104-108 [in Ukrainian].

Sabatine, M.S., Giugliano, R.P., & Keech, A.C. (2017). Evolocumab and clinical outcomes in patients with cardiovascular disease. N. Engl. J. Med. 376, 1713-1722

Strobl, F.F., Brechtel, K., & Schmehl, J. (2013). Twelve-month results of a randomized trial comparing mono with dual antiplatelet therapy in endovascularly treated patients with peripheral artery disease. J. Endovasc. Ther., 20, 699-706.

Teraa, M., Conte, M.S., Moll, F.L., & Verhaar, M.C. (2016). Critical limb ischemia: current trends and future directions. J. Am. Heart Assoc., 5, e002938.

Hoshchynskyi, V.B., Piatnychka, O.Z., Mihen­ko, B.O. (2018). Mistse terapevtychnoho neoanhio­he­nezu v likuvanni krytychnoi ishemii nyzhnikh kintsi­vok [The place of therapeutic neoangiogenesis in the treatment of critical ischemia of the lower extremities]. Art of Medicine, 4 (8), 44-47 [in Ukrainian].

Kalinin, R.E., Pshennikov, A.S., & Suchkov, I.A. (2015). Reperfuzionnoe povrezhdenie tkaney v khirurgii arteriy nizhnikh konechnostey [Reperfusion tissue da­mage in surgery of lower limb arteries]. Novosti khirurgii – Surgery News, 3 (23), 348-352.

Antoniou, G.A., Fisher, R.K., Georgiadis, G.S., Antoniou, S.A., & Torella, F. (2014) Statin therapy in lower limb peripheral arterial disease: systematic review and meta-analysis. Vascul. Pharmacol., 63, 79-87.

Dubinina, E.E., Salnikova, L.Ya., & Efimova, L.F. (1983). Aktivnost i kofermentnyy spektr SOD eritrotsitov [Activity and coenzyme spectrum of red blood cell SOD]. Lab. delo. – Laboratory Case, 10, 30-33 [in Russian].

Fakhry, F., Spronk, S., & van der Laan L. (2015). Endovascular revascularization and supervised exercise for peripheral artery disease and intermittent claudication: a randomized clinical trial. JAMA, 314, 1936-1944.

Published
2019-11-07
How to Cite
Kolotylo, O. B. (2019). CORRECTION OF PROOXIDANT-ANTIOXIDANT EQUILIBRIUM IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES AND A HIGH RISK OF DEVELOPMENT OF REPERFUSION-REOXIGENATION COMPLICATIONS. Medical and Clinical Chemistry, (3), 92-96. https://doi.org/10.11603/mcch.2410-681X.2019.v.i3.10564
Section
ORIGINAL INVESTIGATIONS