COMPARISON OF PREOPERATIVE IMMUNOLOGICAL PARAMETERS IN SURGICAL PATIENTS WITH DIFFERENT FORMS OF INFECTIVE ENDOCARDITIS
The complex of the pathological implications developing at an infectious endocarditis includes implications of a sepsis, a heart and multiorgan failure, and also from an orientation and expression of immune reactions of an organism. The purpose of the study was to compare preoperative markers of immunological reactivity and to reveal their predictive value in adult surgical patients with infective endocarditis. The data of 246 patients was studied, native valve infective endocarditis was in 223; prosthetic valve infective endocarditis was in 23 patients, acute native valve infective endocarditis occurred in 56, subacute - in 190 cases. The control group consisted of 20 patients without infection. Significant changes in immunological parameters were found in all groups: cellular immunity has shown the decrease of the majority of cellular subpopulations and activation of cytotoxic T-lymphocytes, changes in humoral immunity included the reduced number of B-lymphocytes and rise of immunoglobulin G level. Different ranges of immunological parameters were revealed in patients with acute and subacute in-infective endocarditis, and infective endocarditis of native and prosthetic valves: in subacute and prosthetic infective endocarditis, lower activities of inflammatory markers and another ranges of T-cells subpopulations were found. Differences between groups were also revealed in levels of phagocytosis, circulating immune complexes and immunoglobulins.