CORRECTION OF PROOXIDANT-ANTIOXIDANT EQUILIBRIUM IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES AND A HIGH RISK OF DEVELOPMENT OF REPERFUSION-REOXIGENATION COMPLICATIONS
DOI:
https://doi.org/10.11603/mcch.2410-681X.2019.v.i3.10564Keywords:
prooxidant-antioxidant system, reperfusion-reoxygenation complications, alpha-tocopherol, quercetin, free radical oxidationAbstract
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.
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