DISTURBANCES OF THE BIOCHEMICAL COMPOSITION OF BILE IN CONDITIONS OF COMBINED ABDOMINAL AND BREAST TRAUMA IN PERIOD OF EARLY MANIFESTATIONS OF TRAUMATIC DISEASE AND ITS CORRECTION WITH THIOTRIAZOLINE
Introduction. Injuries continue to be the most common cause of death worldwide. In the structure of combat trauma, blunt and penetrating injuries to the chest and abdomen occupy the third place, second to the injuries to the extremities and the head.
The aim of the study – to find out character of disturbance of bile-forming function of a liver under the conditions of the combined injury of abdomen and a chest of rats in the early period of traumatic illness and to evaluate the effectiveness of its correction with thiotriazoline.
Research Methods. The experiments were performed on 86 non-linear white male rats weighing 200–220 g, which were divided into five groups: control and four experimental. Injuries were inflicted under thiopental sodium anesthesia at a dose of 40 mg/kg animal weight. The control group included intact animals that were only anesthetized. In experimental group 1 rats were simulated chest injury, in group 2 – blunt abdominal injury, 3 – combined injuries, 4 – animals with combined trauma were injected intraperitoneally with tiotriazoline at a dose of 9.1 mg·kg-1 . After 1, 3 and 7 days after the injury under the conditions of thiopental sodium anesthesia, rats were catheterized into the common bile duct and bile was collected for 60 min, in which the concentration of total bile acids and cholesterol was determined, and the cholate-cholesterol ratio was calculated.
Results and Discussion. In the application of isolated injuries of the chest, abdomen and their combination, the bile-forming function of the liver was significantly impaired, which was manifested by a decrease in the synthesis of cholates and an increase in the cholate-cholesterol ratio. The severity of liver dysfunction can be divided as follows: isolated chest injury←isolated abdominal injury←combined injury. As a result of the violations found, the cholate-cholesterol ratio increased significantly, which was dominated by isolated abdominal trauma and combined trauma. Shifting the balance toward cholesterol accumulation increased the lithogenic properties of bile. The seven-day administration of thiotriazoline in the group of animals with combined trauma significantly increased the total bile acid content in the bile, increased the cholate-cholesterol ratio, did not affect the cholesterol concentration in the bile.
Conclusions. Combined abdominal and thoracic trauma contributes to a greater reduction in liver functional capacity compared to isolated lesions. It is based on the inhibition of synthetic processes in the microsomal system of hepatocytes. Thiotriazoline is able to reduce the negative impact of pathogenic factors of trauma on the functional capacity of hepatocytes, which should be taken into account in the intensive care of combined abdominal and breast trauma.
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