Affiliation:
1. Higher State Educational Establishment of Ukraine «Bukovinian State Medical University»
Abstract
The research presents treatment results of
patients with peritonitis by using the personalized
medicine principles, which are based on the choice
of diagnostic, treatment and preventive measures
taking in to account genetic, physiological,
biochemical and other features of the patient.
Purpose of the study. The treatment results
improvement of patients with peritonitis, the
reduction of the complications frequency.
Materials and methods. 226 patients
with signs of acute peritonitis had complex
examination with serum cytokines and serotonin
levels determination and analysis of the
polymorphic sites alleles of IL1ß (-511C / T) and
5-HTTLPR genes by polymerase chain reaction
evaluated the treatment outcomes using the
developed algorithms. The treatment results with
the use of developed algorithms were evaluated.
Results. The processes of peroxide oxidation,
antioxidant protection, proteolysis, fibrinolytic
activity and their role in systemic disorders of
homeostasis are shown. The connection between the
nature of inflammatory reactions, its distribution in
the peritoneal cavity and variants of the IL1ß gene
(-511C/T) was proved. The relationship between
the character of intestinal motility disorders
in the postoperative period and variants of the
5-HTTLPR gene, which regulates the serotoninergic
mechanisms of intestinal contractility, is shown.
The algorithms for personalized approach to the
peritonitis diagnostics, prognosis of and choice of
treatment tactics were developed on the basis of
the identified genetically determined individual
characteristics of the inflammatory process.
Advanced stages of surgical intervention were
developed. Conclusion. Prediction of the course of peritonitis
and the development of various complications based
on genetic research allows developing algorithms
of personalized therapeutic tactics, significantly
improving the results of its treatment.
Keywords: peritonitis, genetic studies,
IL1β (-511C/T), 5-HTTLPR, diagnostics and
treatment algorithms, personalized medicine.
Publisher
Zaporizhia Medical Academy of Post-Graduate Education
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