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Medicinski časopis
2016, vol. 50, br. 1, str. 17-25
jezik rada: srpski
vrsta rada: pregledni članak
objavljeno: 27/10/2016
doi: 10.5937/mckg50-11448
Prediktivni značaj mijeloperoksidaze za nastanak postoperativnih vaskularnih komplikacija
aUniverzitet u Prištini sa privremenim sedištem u Kosovskoj Mitrovici, Medicinski fakultet, Kliničko-bolnički centar
bKlinički centar Kragujevac, Klinika za opštu i grudnu hirurgiju + Univerzitet u Kragujevcu, Medicinski fakultet
cDom zdravlja 'Medicus Universalis', Kraljevo

e-adresa: drmspasic@gmail.com

Sažetak

Nova saznanja o delovanjima mijeloperoksidaze u toku inflamatornog procesa povezanog sa infekcijama i vaskularnim lezijama ukazuju na njenu ulogu u stanju oksidativnog stresa i endotelne disfunkcije i na njen prediktivni značaj za nastanak kardiovaskularnih insulta. Produkti delovanja mijeloperoksidaze predstavljaju integrativni mehanizam koji povezuje lezije tkiva, infekcijski, inflamatorniproces, oksidativni stres, endotelnu disfunkciju i nastanak vaskularnih insulta (najčešći su arterijska i venska tromboza i konsekutivne embolije). Najčešće komplikacije operativnog hirurškog lečenja su vaskularne. Posmatrano s konzervativnog stanovišta najčešće su arterijska i venska tromboza, ali šire gledano dehiscencija sutura bi se mogla smatrati posledicom poremećene mikrocirkulacije. Sama operativna procedura kao i osnovni patološki supstrat dovode do aktiviranja inflamatorne kaskade sa aktivisanjem ćelija mijeloidne loze, pri čemu dolazi do oslobađanja i aktivisanja mijeloperoksidaze koja pored antimikrobnog ispoljava mnogostruka vaskularna dejstva. Povećana koncentracija mijeloperoksidaze u plazmi i do tri meseca pre kliničke ekspresije vaskularnog insulta ukazuje na njen prediktivni značaj. Aktuelna istraživanja predočavaju mogućnost uspešnog korigovanja posledica delovanja mijeloperoksidaze i prevenciju vaskularnih komplikacija.

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