PROTEOLYTIC SYSTEM CONDITION AS IN THE CASE OF NEUTROPHIL ELASTASE IN PATIENTS WITH TROPHIC ULCERS ON THE BACKGROUND OF DIABETES MELLITUS
Abstract
Relevance. According to the WHO and the International Diabetes Federation (IDF), the number of patients with diabetes in the world reached 463 million people in 2019. A typical manifestation of complications of diabetes mellitus is the development of trophic ulcers of the lower extremities, which leads to poor quality of life, disability, and high financial costs for treatment
Objective. To study the effect of autogenic platelet-rich plasma (APRP) on fluctuations of neutrophil elastase level in patients with trophic ulcers on the background of diabetes mellitus, which may help influence the pathogenesis of ulcer formation in DFD.
Materials and methods. Ninety-eight patients with neuropathic ulcers of diabetic origin, divided into two groups, were treated at the Burn Department and the Vascular Surgery Department of Sumy Regional Clinical Hospital. The comparison group (Group II) included 47 patients who received treatment according to the standard scheme. The main (Group I) included 51 patients who had the standard scheme supplemented with platelet-rich autoplasma. The control group included 20 practically healthy people. To obtain the objective, we investigated the changes in elastase levels from the day of hospitalization up to the 20th day of treatment. The study took 25‒30 minutes.
Conclusions. The study found that the average level of neutrophil elastase in patients of the main group was 272.4 ± 4.2 nmol/(min • mL). The average neutrophil elastase level in the subjects of the comparison group was 274.2 ± 3.2 nmol/(min • mL). The levels in both groups were 3.8 times higher than that in the control group (p<0.05).
On day 20 of treatment, the level of neutrophil elastase in the main group decreased to 93.24±1.78 nmol/ min • mL. In patients of the comparison group, the elastase level decreased to 164.17±2.00 nmol/ min • mL. The decrease in neutrophil elastase levels in the main group occurred significantly faster than that in the comparison group, which indicated a positive effect of autogenic platelet-rich plasma on the corresponding link in the pathogenesis of ulcerative defect.
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