Year 2010 Vol. 18 No 4

GENERAL AND SPECIAL SURGERY

P.V. SARAP, Y.S. VINNIK, A.A. OSTANIN

FEATURES OF CONDITION SEVERITY IN PATIENTS WITH URGENT SURGICAL PATHOLOGY FROM THE CONCEPT OF CLUSTER ORGANISATION OF IMMUNE RESPONSE

Objectives. To allocate separate variants (clusters) of the immune response organization in the patients with urgent abdominal surgical pathology and to estimate interrelation between condition severity and distance of their indicators from the cluster center (DC).
Methods. 442 patients were examined. Using the factorial analysis the most informative indicators for clusterisation were determined: quantity CD3+, CD4+, CD8+, CD16+ lymphocytes. 6 clusters of the immune status were allocated. To estimate the interrelation of indicators the correlation and dispersive analyses were applied.
Results. In all clusters the DC directly correlates with condition severity and higher functional loading on immune system. It confirms assumptions of more rational immune response organization in the patients which indicators are most approached to the centers of clusters. Scales of severity are true for each cluster.
Conclusions. It is appropriate to consider the organization and functions of the immune system from the concept of fundamental knowledge about difficult self-regulated systems organization. Researches open prospects in working out of new criteria of patients’ severity estimation, the forecast of a current and an outcome of diseases, a choice of the most effective tactics of treatment.

Keywords: urgent surgery, immunity, severity, clusters
p. 41-48 of the original issue
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