ОСОБЕННОСТИ ФЕНОТИПА Т-ЛИМФОЦИТОВ У БОЛЬНЫХ С ПРОЛЕЖНЯМИ

The immune system takes an active part in maintaining the integrity of the anatomical barriers of the skin. Consequently, the development of new methods for the prevention and treatment of pressure injuries due to the regulation of immune processes is promising. Objective – to study the peculiarities of the phenotypes of peripheral blood T-lymphocytes in patients with pressure injuries. Materials and methods. Surgical patients (33 men and 34 women) with complications in the form of pressure injuries were examined. The assessment of the development of the pressure injury process was carried out according to the GOST R 56819-2015 with the determination of the severity of the pressure injuries according to the international recommendations of the NPUAP/EPUAP. The study of the phenotypes of T-lymphocytes was carried out by flow cytometry of whole peripheral blood. Statistical analysis was carried out with Statistica 8.0 (StatSoftInc., 2007) application package. Results. Lymphocytosis was found in patients with pressure injuries with mild severity, with a small lesion area (up to 5 sq. cm) and a favorable outcome of the disease. Lymphopenia was revealed in patients with a severe degree, a large area of pressure injuries (more than 5 sq. cm) and an unfavorable outcome of the disease. The absence of an increase in the number of T-regulatory cells with an increase in the number of T-helpers was found in patients with a high degree of severity. A high level of gdT-lymphocytes in the blood was found in patients with a large area of pressure injuries. A pronounced increase in activated T-lymphocytes (CD3 + HLA-DR + ) was determined with an unfavorable outcome of the disease. Conclusion. The development of pressure injuries is associated with pronounced changes in T-cell immunity. In this case, a special role is played by the population of T-regulatory cells, which suppress not only adaptive but also innate immunity. Inflammation progresses in the absence of such suppression and negative dynamics of the development of pressure injuries is observed. The skin can be considered as an organ of the immune system. Therefore, it can be assumed that the use of immunoactive therapy primarily aimed at regulatory mechanisms in the immune system will prevent the development of pressure injuries and promote their healing.