RESUMEN
A total of 136 patients with open mandibular fractures were examined, 53 of these at risk of inflammatory complications in the posttraumatic period. Analysis of the wound cytology, hematological changes, local and system immunity reactions suggest that phagocytosis dysfunction, imbalance of local immunity factors (primarily production, complex formation, and secretion of serum IgA) are significant factors in the development of posttraumatic immune deficiency. Statistical analysis showed clear-cut correlation between local immunity parameters (serum IgA, salivary IgG, levels of circulating immune complexes and medium-weight molecules in the saliva) and hematological values (leukocyte and lymphocyte counts, leukocytic intoxication index, and Rietes coefficient), which confirmed the reliability of prediction of inflammatory complications and necessity of immunocorrection in this patient population.
Asunto(s)
Curación de Fractura/inmunología , Fracturas Abiertas/diagnóstico , Fracturas Abiertas/inmunología , Fracturas Mandibulares/diagnóstico , Fracturas Mandibulares/inmunología , Adolescente , Adulto , Complejo Antígeno-Anticuerpo/sangre , Fracturas Abiertas/complicaciones , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/análisis , Masculino , Fracturas Mandibulares/complicaciones , Persona de Mediana Edad , Pronóstico , Reproducibilidad de los Resultados , Saliva/inmunologíaRESUMEN
Despite great differences in the patients with complicated and uncomplicated mandibular fractures, the activity of serum transaminases reflects the severity of damage to osteomuscular tissue and time course of development of inflammatory reaction. The leukocytic intoxication index (LII) characterizes stress reaction of the blood system during the first hours and development of inflammation in later periods of the posttraumatic period. The ratio of de Ritis coefficient/LII indicates the level of endogenous intoxication, cell membrane permeability, development and time course of the inflammatory process. Hence, these parameters are diagnostically and prognostically significant for predicting the outcome of the posttraumatic period and serve as criteria for development of optimal treatment algorithms.