CHANGES IN HYPOTHALAMIC-PITUITARY-ADRENAL AND IMMUNE SYSTEMS IN WOUNDED WITH COMBAT LIMBS INJURIES IN THE CONDITIONS OF MILITARY CONFLICT IN DONBASS
Abstract
us in 83 wounded with gunshot limbs wounds were studied in 1-3, 7, 14, 21 and 28 days after trauma. All the wounded were men, the average age was 32.7 ± 4.3 years (20-48). Bullet wounds occurred in 29 (34.94%) of the victims, explosive trauma – in 54 (65.06%). Isolated damages of segments of the musculoskeletal system were established in 34 (40.97%) of the wounded, multiple – 31 (37.35%), associated – 18 (21.69%). As a control, 20 healthy soldiers and 19 civilians were examined. It is shown that extreme situations in the conditions of military operations caused a high level of cortisol in the blood serum and the development of chronic stress in healthy soldiers. It was established that in wounded with gunshot limb injuries the level of cortisol in the blood serum exceeded its content in healthy military personnel by 2.5 times, starting from the first day and throughout the period of the examination up to 28 days or more after the trauma. Changes in immune system in the wounded were characterized by an increase in the number of leukocytes, lymphocytes, T-lymphocytes and their regulatory subpopulations, and B-lymphocytes during the first 14 days after injury. Normalization of leukocyte and lymphocyte counts, as well as B-lymphocyte counts was recorded after 21 days after injury, which correlated with the healing of soft tissues. Elevated levels of cortisol in the blood serum of the wounded exerted a stimulating effect on the T-system of immunity throughout the study period, and thus maintained an aseptic inflammatory process that was a risk factor for delayed fracture consolidation.
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