CHARACTESTICS OF CHANGES IN SOME PARAMETERS OF LIPID METABOLISM IN OBSTRUCTIVE YAUNDICE

Malyk S. V., Ksоnz I. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The actual problem in the clinical surgery is a syndrome of obstructive jaundice. This is due to the difficulty and irregular of diagnosis, severity of clinical course, the development of numerous complications dangerous for life, unsatisfactory treatment results. The idea of changing the lipid metabolism with obstructive jaundice are controversial nature, little known is the question of dependence of duration on lipid metabolism and jaundice after its removal. The aim of our study was to examine the state of lipid metabolism in patients with obstructive jaundice of various origins. There was carried out the analysis of complex examination at the process of surgical treatment of 110 patients suffered from obturative jaundice. Special attention was paid on changes of lipid metabolism. The causes of jaundice were choledocholithiasis, large duodenal papilla stenosis, scar stricture of bile duct tumors of the liver, bile ducts and pancreatic head. All patients, along with medical history survey, physical examination, conventional laboratory protocol and instrumental studies determined the total lipids via sulfofosfovanilinovoyi reaction, cholesterol by method by Kalka, phospholipids by Fiske, α- and β-lipoproteins by electrophoresis on paper. All patients were performed the surgery techniques aimed at eliminating the obstruction of the bile ducts and adequate flow of bile into the digestive tract. In the postoperative period generally conducted events and rehabilitative therapies, biochemical blood tests were carried out at 3, 7, 14 days after surgery. Pay attention to the changes in lipid metabolism depending on the duration of jaundice. The greater the duration of jaundice, the level was more pronounced increase in total lipids and β-lipoprotein, while the level of α-lipoprotein decreased. Patients of the first group of short course jaundice experienced a slight increase of total lipids and β-lipoprotein, where as cholesterol and phospholipids remained within normal limits, and α-lipoprotein levels decreased significantly. It was determined that in patients with obturative jaundice there early occur changes of inflammatory character in the liver. This is confirmed by the data of laboratory investigations, informatively reflect changes of lipid metabolism indexes. These changes are stipulated by the complex of physiological violations in the organs of hepatopancreatobiliar zone. In case of obstructive jaundice is fairly informative lipid metabolism changes of serum. These changes in lipid metabolism due to operation complex physiological disorders in organs hepatopancreatobiliar areas, including liver dysfunction, the flow of bile in the gastrointestinal tract and its exclusion from the process of digestion, lack of lipolytic pancreatic function. The most informative in obturative jaundice may be considered such changes of lipid metabolism indexes as the level general lipids riding, the level of lowering of α-lipoproteins and rising of β- lipoproteins. This may be used as а complex of prognostic criteria of the disease.

obturative jaundice, diagnosis, lipid metabolism, prognostic criteria

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«Bulletin of problems biology and medicine» Issue 1 part 1 (126), 2016 year, 190-193 pages, index UDK 616.36 – 008.5 : 612.015.397