INFLUENCE OF THE ACUTE INFLAMMATION AND ENDOTHELIAL DYSFUNCTION ON THE RETINAL VEIN OCCLUSION FORMATION AFTER CARDIO-SURGICAL INTERFERENCES WITH THE USE OF CARDIOPULMONARY BYPASS
Acute inflammation and endothelial dysfunction (EDF) are typical pathological processes, which determine the development of retinal vein occlusion (RVO) during cardio-surgery with the use of cardiopulmonary bypass (CB), but the connection of seromarkers according to the terms of occlusion appearance remains undefined.
The aim – to determine the influence of the acute inflammation and EDF for RVO formation after cardio-surgical interferences with the use of CB according to the terms of occlusion appearance.
Material and methods. There were selected for the research the data of 137 eyes (126 patients, the main group) with RVO after the surgery with CB. The comparison group contains the data about examination of 86 eyes (43 patients), who had not any occlusion during all term of examination. The control group consisted of 10 eyes (5 patients) without occlusion, which were examined before surgery. An ophthalmologist 2, 7, 30, 60, 90 and 180 days after cardio-surgical interference, examined patients. The content of IL-6, IL-8 and VE-cadherin in blood serum was determined by immunoenzyme technique (Bender Medsystems, Austria). Statistical data processing was performed with the use of Statistica 10 program (StatSoft, Inc., USA), regression analysis – with the use of the program package GLZ.
Results. The conduction of cardio-surgeries with the use of CB caused an increase of the interleukins content in the early period (IL-6 on the 2nd and 7th days, and IL-8 up to 30 days), while the content of VE-cadherin (VE-C) was slightly increased during almost all period of monitoring. With the availability of RVO, the content of IL-6 during all terms of occlusion appearance was significantly higher, the content of IL-6 was up to 30 days, and the content of VE-C in a greater degree was after the 7th day.
The regression analysis showed that after 1-2 days RVO appearance was directly related with the content of IL-6 and IL-8 in the blood, on the 3rd and 7th days – only with the content of IL-8, on the 8th and 30th days – with the content of all markers, and then with the content of IL-6 and VE-C. The accuracy of the prediction of the presence or absence of RVO at the appropriate period according to the calculated regression model is at least 78 % (p <0.001), what proves the influence of markers on the development of RVO.Conclusions. The undertaken study shows the meaning of the acute inflammation and EDF by appearance of RVO with the use of CB, what justifies the application of the preventive measures - at the early stages the restriction of activity of the inflammatory process, at the later stages – prevention of EDF development.
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