ОСОБЕННОСТИ ФЕНОТИПА В-ЛИМФОЦИТОВ КРОВИ В ЗАВИСИМОСТИ ОТ ИСХОДА РАСПРОСТРАНЕННОГО ГНОЙНОГО ПЕРИТОНИТА

The aim of the study was to investigate the phenotypic consiston of peripheral blood B-lymphocytes in patients with widespread purulent peritonitis (WPP) in the dynamics of postoperative treatment depending on the outcome of the disease. 52 patients with acute surgical diseases and injuries of the abdominal organs complicated by WPP were examined. Blood sampling was performed before surgery (preoperative period), as well as on the 7th, 14th and 21st day of the postoperative period. All patients with WPP were divided into two groups in depending on the outcome of the disease in the postoperative period: patients with a favorable outcome of the disease (n = 34), patients with an unfavorable outcome (n = 18). 68 healthy people were examined as a control. The phenotype of blood B-lymphocytes was studied by flow cytometry using direct immunofluorescence of whole peripheral blood with monoclonal antibodies. It was established that in the preoperative period in patients with WPP against the background of a low absolute level of B-lymphocytes in the blood, a decrease in the content of B1 cells relative to control values was detected. Moreover, a higher number of activated (according to CD23) B1 lymphocytes in the blood is observed in the patients with an unfavorable outcome of WPP than in the patients with a favorable outcome of the disease. The dynamics of changes in the content of B-lymphocytes in the observed period after surgery (7-21 days) varies significantly in depending on the outcome of the disease. There is a decrease in the number of most subpopulations of B-lymphocytes (including activated cells) in patients with a favorable outcome of WPP during the postoperative period, whereas the levels of various fractions of B-cells in patients with an unfavorable outcome of the disease in the postoperative period practically do not change. The number of total B-lymphocytes, naive B-cells and B2-lymphocytes non-expressing and expressing the CD23 receptor in patients with an unfavorable outcome of WPP were higher in during the entire postoperative period than in patients with a favorable outcome of the disease. The content of some other fractions of B-lymphocytes in patients with an unfavorable outcome was also higher than with a favorable outcome of WPP but only at certain stages of postoperative treatment. It is assumed that the established features in the levels of B-lymphocytes in the blood in depending on the outcome were determined by the fact that the patients with an unfavorable outcome of WPP had reduced the level of cell migration in the framework of the development of the immune response as well as a reduced level of sensitivity of the immune system to postoperative antibiotic therapy.