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
DOI:
https://doi.org/10.11603/mcch.2410-681X.2019.v.i4.10842Keywords:
combined trauma, breast, abdomen, bile formation, thiotriazolineAbstract
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.
References
Bouglé, A., Harrois, A., & Duranteau, J. (2013). Resuscitative strategies in traumatic hemorrhagic shock. Annals of Intensive Care, 3, 1, 1. DOI: https://doi.org/10.1186/2110-5820-3-1
Sarychev, L.P., Sarychev, Y.V., Pustovoyt, H.L., Sukhomlin, S.A., & Suprunenko, S.M. (2018). Management of the patients with blunt renal trauma: 20 years of clinical experience. Wiadomości Lekarskie, 71 (3 pt. 2), 719-722.
Huriev, S.O., Fil, A.Yu., & Tanasiienko, O.M. (2015). Analiz bezposerednikh prychyn smerti u postrazhdalykh iz politravmoiu ta poshkodzhenniam skeleta [Analysis of immediate causes of death in victims with polytrauma and skeletal damage.]. Travma – Trauma, 16, 4, 7-10 [in Ukrainian].
Fil, A.Yu. (2014). Khirurhichna kontseptsiia likuvannia postrazhdalykh iz politravmoiu u hostromu periodi [Surgical concept of treatment of victims with polytrauma in the acute period]. Travma – Trauma, 15, 5, 20-23 [in Ukrainian].
Haida, I.M., Badiuk, M.I., & Sushko, Yu.I. (2018). Osoblyvosti struktury ta perebihu suchasnoi boiovoi travmy u viiskovosluzhbovtsiv Zbroinykh Syl Ukrainy [Peculiarities of structure and current of modern combat trauma among servicemen of the Armed Forces of Ukraine]. Patolohiia – Pathology, 15, 1, 73-76 [in Ukrainian].
Prydruha, S.M. (2013). Pathogenetic features the late current manifestations in an experiment traumatic disease and its correction tiotryazolin. Journal of Health Sciences, 3, 111-120.
Hudyma, A.A., & Pidhirnyi, V.V. (2007). Vplyv lansoprazolu, metronidazolu i klarytromitsynu na funktsionalnyi stan pechinky i yoho korektsiia tiotryazolinom v umovakh khronichnoho eksperymentalnoho hepatytu [Influence of lansoprazole, metronidazole and clarithromycin on the functional state of the liver and its correction with thiotriazolin in conditions of chronic experimental hepatitis]. Zaporizkyi medychnyi zhurnal – Zaporizhzhia Medical Journal, 5, 33-37 [in Ukrainian].
Stefanov, O.V. (Ed.). (2001). Doklinichni doslidzhennia likarskykh zasobiv: metodychni rekomendatsii [Preclinical drug studies: guidelines]. Kyiv: Avitsenna [in Ukrainian].
Hudyma, A.A., Mykhailiuk, I.A., & Mykhailiuk, V.M. (2015). Dynamika pokaznykiv zhovchoutvoriuvalnoi funktsii pechinky u vidpovid na skeletnu, cherepno-mozkovu ta poiednanu travmu v rannii period travmatychnoi khvoroby [Dynamics of the indices of liver biligenetic function in reply to skeletal, cranial-cerebral and combined traumas in the early period of the traumatic disease]. Medychna i klinichna khimiia – Medical and Clinical Chemistry, 17, 3, 66-69 [in Ukrainian].
Volotovska, N.V., Cliff Nhokwara, T., & Zhulkevych, I.V. (2019). Zminy aktyvnosti hlutationovoi systemy vnutrishnikh orhaniv u pershi hodyny eksperymentalnoho ishemichno-reperfuziinoho syndromu kintsivky, poiednanoho z krovovtratoiu ta mekhanichnoiu travmoiu [Changes in the glutathione systems activity of internal organs in the first hours of experimental limb ischemia-reperfusion syndrome, combined with blood loss and mechanical injury]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, (1), 23-27 [in Ukrainian]. Retrieved from: https://doi.org/10.11603/1811-2471.2019.v0.i1.10043 DOI: https://doi.org/10.11603/1811-2471.2019.v0.i1.10043
Zachepa, O.A., & Sushko, Yu.I. (2019). Porushennia antyoksydantno-prooksydantnoho balansu v pechintsi za umov poiednanoi abdominalnoi i torakalnoi travmy [Violation of antioxidant-prooxidant balance in the liver under conditions of combined abdominal and thoracic trauma]. The All-Ukrainian Scientific and Practical Conference: Ekstrena medychna dopomoha v nadzvychainykh umovakh – Emergency Emergency Medical Services. (pp. 45-46). Ternopil: Ukrmedknyha [in Ukrainian].
Volotovska, N.V., & Hudyma, A.A. (2011). Rol hemichnoi hipoksii v patohenezi porushen zhovchoutvoriuvalnoi i zhovchovydilnoi funktsii pechinky na tli skeletnoi travmy v rannomu posttravmatychnomu periodi [The role of hemic hypoxia in the pathogenesis of disorders of the biliary and biliary functions of the liver and the background of skeletal trauma in the early post-traumatic period]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, 2 (15), 31-33 [in Ukrainian].
Chekman, I.S., Posokhova, Ye.A., & Beregovaya, Ye.G. (1996). Mikrosomalnaya fermentnaya sistema organizma [Microsomal enzymatic system of the body]. Kyiv [in Russian].
Belenichev, I.F., Vizir, V.A., Mamchur, V.I., & Kuryata, A.V. (2019). Mesto tiotriazolina v galereye sovremennykh metabolitotropnykh lekarstvennykh sredstv [The place of thiotriazolin in the gallery of modern metabolitotropic drugs]. Zaporozhskiy meditsinskiy zhurnal – Zaporozhye Medical Journal, 21, 1, 118-128 [in Russian].
Dronov, O.I. Kovalska, I.O., Zemskov, S.V., Kozachuk, Ye.S., Bakunets, P.P., & Zhulkevych, I.V. (2019). Otsinka bezpechnosti vnutrishnopechinkovoho vvedennia 10 % rozchynu kaltsiiu khlorydu u shchuriv linii wistar: eksperymentalne doslidzhennia [Safety assessment of intrahepatic injection of 10 % calcium chloride solution in wistar rats: experimental study]. Zdobutky klinichnoi i eksperymentalnoi medytsyny – Achievements of Clinical and Experimental Medicine, 2, 125-129 [in Ukrainian].
