Дослідження клітинної ланки імунітету при травматичних переломах нижньої щелепи в постраждалих різного психосоматичного типу особистості

Abstract

Вивчено особливості реакції клітинної ланки імунітету на травму в 60 постраждалих із травматичними переломами нижньої щелепи різного психосоматичного типу особистості, серед яких було 36 екстравертів і 24 інтроверти. Отримані результати свідчать про тотальну депресію в них клітинної ланки імунітету в 1-й день після травми. Стабілізація порушених ланок відбувалася по-різному. У осіб-екстравертів на 7-й день після травми відбувалася стабілізація тільки субпопуляцій СD3+-, СD8+-, СD16+-лімфоцитів, а в осіб - інтровертів – СD4+- і СD16+-лімфоцитів; Изучены особенности реакции клеточного звена иммунитета на травму в 60 пострадавших с травматическими переломами нижней челюсти разного психосоматического типа личности, среди которых было 36 экстравертов и 24 интроверта. Полученные результаты свидетельствуют о тотальной депрессии у них клеточного звена иммунитета в 1-й день после травмы. Стабилизация нарушенных звеньев происходила по-разному. У лиц-экстравертов на 7-й день после травмы происходила стабилизация только субпопуляций СD3+ -, СD8+ -, СD16+ лимфоцитов, а у лиц - интровертов - СD4 + - и СD16 + лимфоцитов; The high risk of purulent complications in treatment of traumatic open mandibular fractures, which frequency is 35-41,0%, is caused by the presence of a significant amount of microflora in an oral cavity, mucous membrane ruptures in the area of fracture and also significantly by body defences state. According to the recent literature, it is established that during treatment of patients with traumatic mandibular fractures their psychosomatic state influences on the development of purulent complications. This influence occurs due to different degree of the effect of psyche on immune system that is crucial in purulent complications development. However, there are no researches in immune perturbations depending on psychosomatic type of personality of patients with mandibular fractures. The aim of the research was to study functional disorders of immune system cellular component in patients with traumatic mandibular fractures depending on psychosomatic type of personality. Material and Methods The dynamics of immune status rate was studied in 60 male patients diagnosed with traumatic unilateral open mandibular fractures in the area of a corner, average age was 25.2±5.0 years old. The patients were divided into two groups: extraverts (the 1st group, 36 individuals), introverts (the 2nd group, 24 individuals) according to the Eysenck’s classification. The researches were conducted on the 1st, 3rd, 7th day after a trauma. Identification of T- and B-lymphocytes was performed by means of Status monoclonal antibodies. The quantity of subpopulations CD3+-, CD4+-, CD8+-, CD16+- lymphocytes was evaluated in percent. Results and Discussion The results of the research of a cellular component of immunity proved the decrease in relative quantity of the general pool of T-lymphocytes (CD3+) in both studied groups. The tendencies of their quantitative changes were similar. However, in the patients of the 1st group (the extraverts) on the 7th day of the research, a complete restitution of the quantity of T-lymphocytes (CD3+) was evinced. This rate even exceeded the level of the control group by 5.1%, whereas in the patients of the 2nd group (the introverts) a complete restitution of the quantity of CD3+- lymphocytes was not evidenced, the quantity was lower by 1.9% in comparison with the control. The decrease of total T- lymphocytes took place due to the decrease in subpopulations of T-helpers (CD4+) and T-suppressors (CD8+). The tendencies of quantitative changes of CD4+- lymphocytes in the compared groups differed in the rate of complete restitution of the quantity to the level of the control group on the 7th day of the research that was evidenced only in the patients of the 2nd group (the introverts) and the rate of the 1st group of patients (extraverts) did not reach the level of the control group. The level of Tsuppressors (CD8+) significantly decreased in both compared groups on the 1st day after trauma, and on the 7th day of the monitoring the rate of the extravert group exceeded the level of the control group, and the introvert group did not reach the control rate. The dynamics of the changes of killer lymphocytes rate proved their higher functional activity in the extraverts. Conclusions The results of the research have proved complete depression of T-cellular component of immunity in both studied groups on the 1st day after trauma. Stabilization of the damaged components of immune system in the compared groups was different. On the 7th day after trauma, the stabilization of CD3+-, CD8+-, CD16+- lymphocytes subpopulations was evidenced in the extraverts, and CD4+- and CD16+-lymphocytes subpopulations reached the norm in the introverts.