Changes in Markers of Inflammation and Endothelial Damage at Noncardiac Surgeries in Elderly Patients
Introduction. An increase in the number of elderly patients is a serious problem for both the surgery and anaesthesiology. The most serious complication of perioperative period in the elderly is the development of myocardial infarction. Endothelial dysfunction plays an important role in the development of ischemic heart disease. The synthesis of endothelin-1 determines endothelial dysfunction and is far ahead of the appearance of clinical signs of disease. Another important marker of complications is interleukin-6 — patients have an activation of the inflammatory process. But there is a little information on the analysis of inflammatory markers in patients with ischemic heart disease in terms of perioperative complications in noncardiac surgery. Objective of the study was to examine and to evaluate the functional state of the endothelium and dynamics of proinflammatory interleukin-6 level in elderly patients with concomitant cardiovascular pathology in pre- and postoperative period of noncardiac surgical interventions. Materials and methods. The study involved 55 patients aged 60 to 82 years, who were admitted to the hospital for elective abdominal surgery. Laboratory studies were performed with the definition of endothelin-1 and interleukin-6 level in EDTA-plasma using enzyme immunoassay. Results. It is proved that elderly patients have increased levels of endothelin-1 and proinflammatory interleukin-6 in the blood plasma, indicating the presence of endothelial dysfunction and activation of proinflammatory system. In the early postoperative period, vascular endothelium responds to operational trauma by a release of vasoconstrictor and proinflammatory markers. By the fifth postoperative day, the signs of endothelial dysfunction and inflammation in the elderly are reduced, but not disappeared completely. Conclusion. Increase in the levels of endothelin-1 and interleukin-6 established in the study confirms the information about their role as markers of endothelial dysfunction.
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