Сучасні аспекти патогенезу та діагностики гострого панкреатиту

Abstract

Early adequate treatment of patients with acute pancreatitis leads to a decrease in mortality and reduces the financial burden on medical institutions and the patient, which encourages the continued search for optimal markers for assessing severity and predicting the course of the disease. The aim of this work is to study the modern aspects of the pathogenesis of acute pancreatitis and the role of various biomarkers in the diagnosis of the severity of the course of the disease and the prediction of its complications. The study of the features of the pathogenesis of acute pancreatitis continues, which naturally contributes to the emergence of new diagnostic markers of this disease. It has been proven that most of the etiological factors that cause acute pancreatitis (alcohol, hypoxia, hypercalcemia, hyperlipidemia, certain pharmacological drugs) also contribute to abnormally high oscillations of the Ca2+ level. Therefore, it can be assumed that in acute pancreatitis, Ca2+ is a common trigger for various etiological factors, which trigger the pathological process. In turn, the enzymatic cascade is the starting point for the development of local and systemic inflammatory reactions, manifested by local and systemic effects. Based on the study of the features of the course of severe forms of acute pancreatitis, we established the role of vitamin D deficiency in the development of the disease. In addition, the study of the activity of tissue plasminogen activator and/or the level of thrombin-antithrombin III complex can be interesting as markers of the development of thrombohemorrhagic complications. An increase in the number of positive results of a serological examination for Helicobacter pylori (immunoglobulin M) in patients with a severe course of acute pancreatitis after 7 days from the moment of hospitalization gives reason to consider this indicator as one of the predictors of the development of purulent complications of the disease. Preliminary studies using the proposed diagnostic markers give encouraging results regarding the prognosis for the disease and the life of this extremely complex category of patients.