Serum and urine biochemical markers dynamics after using of laser therapy in patients with chronic posttraumatic osteomyelitis from endemic iodine deficiency regions
The problem of diagnostic evaluation and treatment of patients with chronic post-traumatic osteomyelitis of long limb bones remains complex, multifaceted and not completely resolved in purulent orthopedics.
Objective: to determine the biochemical markers of bone tissue in the blood and urine of patients with post-traumatic osteomyelitis for the primary assessment of their condition and control of the effectiveness of treatment.
Methods: 47 patients were treated with post-traumatic osteomyelitis: 1st group (10 persons) received from non-endemic areas, 2nd (10) and 3rd (27) — f rom endemic (with iodine deficiency). In the 1st a nd 2 nd g roups t he s tandard t reatment s cheme w as used, in the 3rd it was supplemented with laser therapy. The controls used indicators of clinically healthy persons (20). Glycoproteins, alkaline and acidic phosphatase activity, sialic acids, chondroitin sulfates, total and ionized calcium were determined in the serum of blood; in the urine — the content of oxyproline and uronic acids.
Results: Patients in group 1 have been gradually lowering biochemical markers of bone destruction and inflammation, starting from 7 days of treatment. Reduction in the level of excretion of oxyproline and uronic acids indicates a slowdown in catabolism of collagen and proteoglycans. In patients in group 2, the decrease in the content of glycoproteins, cholesterol and haptoglobin in serum was noted only 14 days after the start of treatment. Patients in the 3rd group recovered biochemical blood and urine output more intensively.
Conclusions: post-traumatic osteomyelitis is characterized by an increase in serum of markers of inflammation and destruction of bone tissue, as well as catabolism of collagen and proteoglycans. The use of the treatment regimen using laser therapy had a higher clinical efficacy, which was confirmed by a decrease in the biochemical markers of inflammation and bone destruction during treatment.
Full Text:PDF (Українська)
Kliushyn NM, Aranovych AM, Shliakhov VY, Zlobyn AV. New technologies of treatment of patients with chronic osteomyelitis - a total of 40 years of experience using the transosseous osteosynthesis method. Orthopedic genius. 2011;(2): 32–8. (in Russian)
Kliushyn NM, Shliakhov VY, Zlobyn AV, et al. Transosseous osteosynthesis in the treatment of osteomyelitis of long bones of the upper limb. Orthopedic genius. 2010;(4):45–50. (in Russian)
Simpson AH, Deakin M, Latham JM. Chronic osteomyelitis. The effect of the extent of surgical resection on infection-free survival. J Bone Joint Surg Br. 2001;83(3):403–7.
Chubeiko VO, Dolhanova TY, Aranovych AM, Kliushyn NM. Changes in the biochemical composition of blood in the development of the syndrome of endogenous intoxication in patients with chronic posttraumatic osteomyelitis of long bones of the lower extremities. Bulletin of the South Ural State University. 2005;4(44):131–3. (in Russian)
Kuznetsova LS, Kliushyn NM, Lapуnyn AY, et al. Carbohydrate-energy metabolism in patients with chronic osteomyelitis. Orthopedic genius. 2002;(2):57–9. (in Russian)
Kyreeva EA, Stohov MV, Luneva SN, et al. Biochemical indices of blood serum of patients with chronic posttraumatic osteomyelitis of the lower leg when treated with the Ilizarov method. Orthopedic genius. 2013;(3):57–60. (in Russian)
Hlukhov AA, Mykulych EV, Alekseeva NT, Ostroushko AP.Indices of Oxidative Stress and Antioxidant Protection as Criteria for the Quality of Treatment of Chronic Experimental Osteomyelitis. Surgery news. 2013;21(6):10–6. (in Russian)
Kyrdei EH, Belokhvostykova TS, Dmytryeva LA. Extracorporeal immunocorrection in the treatment of chronic osteomyelitis. Siberian Medical Journal. 2001;(3):39–42. (in Russian)
Zhurakovskii IP, Bithaeva MV, Arkhipov SA, et al. Influence of cytokine balance disorders on the morphology of intervertebral discs. Bulletin of the Novosibirsk State University. 2013;(1):236–42. (in Russian)
Ata Y, Inaba Y, Choe H, Kobayashi N, Machida J, Nakamura N, Saito T. Bone metabolism and inflammatory characteristics in 14 cases of chronic nonbacterial osteomyelitis. Pediatr Rheumatol Online J. 2017;15(1):56. doi: 10.1186/s12969-017-0183-z.
Jiang N, Qin CH, Hou YL, Yao ZL, Yu B. Serum TNF-α, erythrocyte sedimentation rate and IL-6 are more valuable biomarkers for assisted diagnosis of extremity chronic osteomyelitis. Biomark Med. 2017 Aug 3. doi: 10.2217/bmm-2017-0082. [Epub ahead of print]
Hofmann SR, Kubasch AS, Range U, Laass MW, Morbach H, Girschick HJ, Hedrich CM. Serum biomarkers for the diagnosis and monitoring of chronic recurrent multifocal osteomyelitis. Rheumatol Int. 2016;36(6):769–79. doi: 10.1007/s00296-016-3466-7.
Kamуshnykov VS. Clinical and biochemical laboratory diagnostics: a reference book. Vol. 1. 2nd ed. Minsk: Interpresservice, 2003. 495 р. (in Russian)
Kamуshnykov VS. Clinical and biochemical laboratory diagnostics: a reference book. Vol. 2. 2nd ed. Minsk: Interpresservice, 2003. 463 р. (in Russian)
Morozenko DV, Leontieva FS. Methods of dosage of markers in the metabolism of spinal tissue in the patient's clinical and experimental medical. Molody Vvcheny: science journal. 2016;2(29):168–72. (in Ukrainian)
Hlants S. Medico-biological statistics. Moscow: Practice, 1998. 459 р. (in Russian)
Copyright (c) 2018 Vasyl Shimon, Volodymyr Kubash, Mykhailo Shimon, Vasyl Stoyka
This work is licensed under a Creative Commons Attribution 4.0 International License.