The study of the immune profile dynemics and the level of endogenous

intoxication in patients with polytrauma

VOLKOVA Yu.V.
Doctor of Medicine, Professor of the Department of Emergency Medicine,
Anesthesiology and Intensive Care
BARANOVA N.V.
Candidate of Medical Sciences, assistant of the Department of Emergency
Medicine, Anesthesiology and Intensive Care
LANTUHOVA N.D.
Candidate of Medical Sciences, assistant of the Department of Emergency
Medicine, Anesthesiology and Intensive Care
KUDINOVA O.V.
Candidate of Medical Sciences, Associate Professor, Department of Emergency
Medicine, Anesthesiology and Intensive Care
Kharkiv National Medical University
Kharkiv, Ukraine
Background: Formation of the reaction of the immune system to the
polytrauma begins with the first minutes of its receipt, the implementation of
adaptive reactions to primary damage with a high risk of multiple organ
disfunction development.
The aim of the study: Study of the immune status level and the severity of
the inflammatory response in patients with polytrauma. Measurement of the level
of C-reactive protein was carried out by a "sandwich - variant" of solid-phase
immuno enzyme analysis.
Materials and research methods: The immune status was studied in 95
patients with polytrauma during the first day after receiving an injury( LII, the
CD3, CD4, CD8 population, the immunoregulatory index, IgG, IgM according to
standard techniques). Measurement of the level of C-reactive protein was carried
out by a "sandwich - variant" of solid-phase immuno enzyme analysis.

Results: The index of LII (leukocyte index of intoxication) was studied, that
was at the level of 0.91 ± 0.08 during the first day (norm - 0.8-1.6). Increasing of
the C-reactive protein in the level of 8 times and amounted to 24.6 ± 4.1 mg/l
(norm-0-3 mg/l). The analysis of primary cellular indicators and humoral immunity
revealed that the relative number of T lymphocytes CD3 was 53.4 ± 4.2%, which
was 21.5% lower than the norm of 58-76%. Expression of the populations of
helpers and suppressors was initially reduced by 11.8% and amounted to 20.3 ±
2.6%, for the CD4 population (norm-23-48%), decreased by 6.5% -15.9 ± 1,6% for
the CD8 population respectively(norm-17-25%). The decrease in immunoreactivity

was confirmed by low values of the immunoregulatory index - 1.28±0.02 (norm-
1.8-2.5). The level of immunoglobulin fractions was within the normal range: for

IgM - 1,01 ± 0,03 g/l(norm-1,19-2,4 g/l). For IgG values were 6.6 ± 0.3g/l(norm -
8-17g/l).
Conclusions: Thus, in response to traumatic effects, on the one hand, there was a
pronounced inflammatory stimulation characterized by high C-reactive protein that
indicates the initiation of an inflammatory response within the next hours after the
injury, on the other hand, there was the hyporeactivity of the cellular and humoral
responses.

07 / The study of the immune profile dynemics and the level of endogenous intoxication in patients with polytrauma