Features of disturbances of microcirculation and intercellular interactions in local cold injury

The aim of the work is to evaluate microcirculation, innervation and intercellular interactions depending on the severity and timing of cold tissue lesions. Materials and methods. 50 patients with III–IV degree of lower extremities local cold injury, as well as their blood were explored. Patients were divided into two groups depending on the period of clinical course: 5 and 30 days of cold injury. At the same time, the patients were divided into 3 groups according to the level of the lesion. The 1 group patients had only fingers frostbitten. Group 2 – patients had lesion boundary extended to the metatarsals and metatarsals. Patients with cold trauma of the proximal segments of the lower extremities belonged to group 3, had the damage level limited by the lower third of the low leg in the most cases. Studies in these groups were carried out on the 5th day after the injury. The phenomenon of lymphocytic-platelet rosette formation and the amplitude of M-response were evaluated. Results. In patients with frostbite, the increased adhesive ability of blood platelets to lymphocytes, was significantly decreased by 30 days. By the day 5, the number of lymphocyte-platelet rosettes increased 2.2 times, and the degree of adhesion 1.7 times. By the day 5 of the injury, the value of the M-response was reduced by 1.7, and the detected changes were preserved for day 30. In patients with fingers frostbitten, the percentage of LTA increased by 1.3 times, and the degree of adhesion by 1.5 times. Registered ENMG potentials decreased by 1.7 times. In group 2, the ability of platelets to adhere to lymphocytes increased by 1.6 times, and the average number of plates participated in rosette formation increased by 2.1. The registered ENMG potentials decreased by 2.5 times. In patients with the maximum level of cold tissue damage, the adhesive ability of lymphocytes and platelets increased by 3 times, and the degree of adhesion increased by 3.5 times, the amplitude of the M-response decreased by 2.6 times. Conclusions. The patients with local cold injury have been demonstrated the increasing of the platelets ability to adhesion to lymphocytes. The increasing of the number and degree of LTA was proportional to the level of tissues damaged by cold. Also, patients with frostbite had a sharp decreasing of in the amplitude of the M-response (motor response), which was getting worse with the increasing of severity of tissue damage. In the case of local cold injury, the maximum activity deviations in the activity of lymphocytic-lamellar interactions and the m-response amplitude of the electroneuromyography were recorded in the early period of cold injury, with a tendency to restore the wound process on the 30th day.

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