Systemic components of pathogenesis of lower-limb atherosclerotic gangrene

Kouzmin V.V., Gusev E.Yu., Yurchenko L.N.

Chair of Anaesthesiology and Resuscitation with a course of transfusiology, Department of Advanced Medical Education and Occupational Retraining, Uralian State Medical Academy of the Russian Public Health Ministry Laboratory of Inflammatory Immunology Institute of Immunology and Physiology under the Uralian Branch of the Russian Academy of Sciences, Ekaterinburg, Russia

A prospective controlled study was carried out in a total of thirty-four patients presenting with atherosclerotic gangrene of the lower extremities. Surgery was preceded by studying haemostasiograms, biochemical parameters and indices of the functional system of detoxication, level of acute-phase proteins, cytokines, stress enzymes. It was determined that irreversibility of tissue damage in atherosclerotic gangrene of the lower limbs results in the development of the main pathogenetic phenomena of systemic impairments, i.e., stress reactions of the neuroendocrine system, systemic inflammatory response, activation of intravascular blood microcoagulation, oxidative stress, crash-like syndrome, autogenous intoxication, latent organic dysfunctions, forming in the aggregate a pathogenetically vicious circle of impairments with local manifestations, pain reaction, and various critical complications of this nosological entity.

KEY WORDS: lower-limb atherosclerotic gangrene, systemic pathogenetic phenomena.

P. 36

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