MODERN ASPECTS OF PATHOGENESIS AND DIAGNOSIS OF ACUTE PANCREATITIS
I.V. Kolosovych, I.V. Hanol
Bogomolets National Medical University, Kyiv, Ukraine
DOI: https://doi.org/10.15407/fz69.01.084
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Abstract
Early adequate treatment of patients with acute pancreatitis
leads to a decrease in mortality and reduces the financial burden
on medical institutions and the patient, which encourages the
continued search for optimal markers for assessing severity
and predicting the course of the disease. The aim of this work
is to study the modern aspects of the pathogenesis of acute
pancreatitis and the role of various biomarkers in the diagnosis
of the severity of the course of the disease and the prediction of
its complications. The study of the features of the pathogenesis
of acute pancreatitis continues, which naturally contributes to
the emergence of new diagnostic markers of this disease. It has
been proven that most of the etiological factors that cause acute
pancreatitis (alcohol, hypoxia, hypercalcemia, hyperlipidemia,
certain pharmacological drugs) also contribute to abnormally
high oscillations of the Ca2+ level. Therefore, it can be
assumed that in acute pancreatitis, Ca2+ is a common trigger
for various etiological factors, which trigger the pathological
process. In turn, the enzymatic cascade is the starting point
for the development of local and systemic inflammatory
reactions, manifested by local and systemic effects. Based on
the study of the features of the course of severe forms of acute
pancreatitis, we established the role of vitamin D deficiency
in the development of the disease. In addition, the study of
the activity of tissue plasminogen activator and/or the level
of thrombin-antithrombin III complex can be interesting
as markers of the development of thrombohemorrhagic
complications. An increase in the number of positive
results of a serological examination for Helicobacter pylori
(immunoglobulin M) in patients with a severe course of acute
pancreatitis after 7 days from the moment of hospitalization
gives reason to consider this indicator as one of the predictors
of the development of purulent complications of the disease.
Preliminary studies using the proposed diagnostic markers give
encouraging results regarding the prognosis for the disease
and the life of this extremely complex category of patients.
Keywords:
acute pancreatitis; pathogenesis; severe course; hemorrhagic and purulent complications; diagnosis; markers.
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