LAUSR

OBJECTIVE The aim: To determine the peculiarities of indicators dynamic of cellular level of immunity in patients with gastroduodenal ulcer complicated by bleeding and microbial contamination the periulcerous area. PATIENTS AND METHODS Materials and methods: 80 patients with gastroduodenal ulcers complicated by bleeding were studied. Among patients in the main group, 18 (22.5%) cases were patients with bleeding gastric ulcer, 56 (70%) patients with bleeding ulcer of duodenum. The study of cellular immunity are B - CD19, Natural killers(NK) - CD16, T-helpers - CD4, T-regulatory - CD8. RESULTS Results: An active bleeding according to the Forrest classification in patients with gastric ulcer 81.7% and in patients with ulcer of the duodenum 88.3%. Depending on the endoscopic hemostasis, there was a marked decrease in T-lymphocyte indices with CD4 growth to the reference rates in cases of active bleeding (from 13±2.4% to 26.4±1.2% p<0.05) and in hemostasis with high recurrence rate from 20.8±2.3% to 31.3±2.9% and from 22.6±1.3% to 39.8±2.9% p<0.05, respectively. CONCLUSION Conclusions: The study found a decrease in CD16 from 3.6±1.1% to 2.6±1.1% (p<0.05) and an increase in the level of CD4, CD8, CD19 to 37.4±1.1%, 4.4±1.1% (p<0.05) and 30.8±1.2% (p<0.05), respectively, indicating that there is a decrease in the immune response in patients with gastroduodenal bleeding of ulcerative genesis. In patients with microbial contamination of the periulcerous area by Streptococcus β-haemoliticus (107 CFU) and Klebsiella pneumoniae (106 CFU), gastric ulcers decreased the level of CD8 population from 7.3±2.1% to 7.3±2.1% to 6.4±7% (p<0.05) and from 5.8±2.8% to 4.1±2.3% (p<0.05), respectively, which may create favorable conditions for the development of recurrent bleeding.