Наявність делеції генів другої стадії детоксикації у хворих на гнійно-запальні захворювання щелепно-лицевої області та цукровий діабет у статистично вірогідній більшості випадків супроводжується гіпоергічою реакцією на запальний процес, уповільненням загоєння рани в післяопераційному періоді. Застосування препарату групи тіопоетинів в комплексному лікуванні гнійно-запальних захворювань щелепно-лицевої області прискорює одужання пацієнтів, зменшує кількість ускладнень.
The purpose of study is to evaluate the effectiveness of medicines with thiopoetine groups in complex treatment of purulent-inflammatory diseases of maxillofacial area in patients with diabetes mellitus.
Materials and methods. 100 patients with odontogenic phlegmon of maxillofacial area were examined. A retro-spective analysis of 130 patient’s case reports has also been carried out. Monitoring groups: 1) patients without diabetes mellitus with GSTM1 and GSTT1 genes poly-morphism; 2) patients with diabetes mellitus with polymorphism of GSTM1 and GSTT1 genes; 3) patients with diabetes mellitus with polymorphism GSTM1 and GSTT1 genes who received for the treatment regimen medicines with thiopoietin groups. All patients were operated and received antibiotic and detoxification therapy. In retro-spective studies, duration of treatment, frequency of complications was determined. In clinical observations, duration of treatment was determined, type of inflammatory reaction: normergic, hyperergic, hypoergic; state of organism non-specific resistance according to thiol-disulphide ratio of blood serum.
Results. As a result of retrospective studies, the duration of treatment of patients with phlegmons of maxillofacial area and concomitant diabetes mellitus on average by 3.3 days is more than in patients without diabetes. The presence of second stage of detoxification genes deletion in patients with diabetes causes statistically significant in-creasing the duration of treatment almost for 2 days (p˂0,05), which is accompanied by increasing of number of hypoergic inflammatory reaction cases. Thus, in case when second stage of detoxification genes deletion ab-sent, the hypoergic inflammatary reaction was observed in 5.0% of patients, with deletion in 35.0% of cases (p = 0.0177). Usig of medicines with thiopoietine groups in complex treatment of purulent-inflammatory diseases of maxillofacial area accelerates patients recovering in average on 2,1 days.
Conclusion. The outcome of odontogenic phlegmon of maxillofacial area in patients with diabetes mellitus is characterized by a longer recovering after surgical intervention, with a greater number of complications. The presence of deletion of the second stage of detoxification in patients with diabetes mellitus in most cases is accomwound healing in postoperative period. The using of medicines with thiopoetine groups accelerates the recovery of patients with odontogenic purulent-inflammatory diseases of maxillofacial area.
Наличие делеции генов второй стадии детоксикации у больных с гнойно-воспалительными заболеваниями челюстно-лицевой области и сопутствующим сахарным диабетом в статистически достоверном большинстве случаев сопровождается гипоэргической воспалительной реакцией, замедлением заживления раны в послеоперационном периоде. Применение препарата группы тиопоэтинов в комплексном лечении гнойно-воспалительных заболеваний челюстно-лицевой области ускоряет выздоровление пациентов, уменьшает количество осложнений.
