Leucocytes index of the intoxication during inflammatory processes of the upper urinary tracts

Abstract

The objective: изучение значения лейкоцитарного индекса интоксикации (ЛИИ) при воспалительных процессах верхних мочевыводящих путей (ВМВП).
Patients and methods. 296 persons have undergone clinic researches: 264 – patients with purulent-infection diseases of the upper urinary tracts, which have been divided into three groups, and 32 healthy persons. 49 persons with infiltrative-inflammatory processes of the upper urinary tracts belonged to the first comparison group. 109 patients with obstructive purulent pyelonephritis without the destruction of kidney parenchyma belonged to the second comparison group. 106 persons with obstructive purulent-pyelonephritis with the destruction of kidney parenchyma belonged to the main group.
Results. The patients of the first comparison group have been subject to antibiotic and disintoxication therapy, in the patients of the second group the upper urinary tracts have been drained by the stent jj. When it was impossible to insert it, percutaneous nephrostome has been used under the ultrasonic control. In the patients of the main group together with the drainage of the upper urinary tracts by the stent jj or by nephrostomy the destruction hotbeds have been drained by inserting the drainage tube under the ultrasonic control.
Conclusions. 1. Before the treatment the leucocytes index of the intoxication corresponded to the average degree of painful illness of endogenous intoxication and the compensated stage of immune insufficiency which equaled 3,73±0,82 conventional units in the patients of infiltrative-inflammatory processes of the upper urinary tracts. After the treatment and the obtaining of positive clinic and laboratory results the improvement of the indices of endogenous intoxication which equaled 1,5±0,16 and positive function of immune system has been observed.
2. Before the treatment in the patients with obstructive inflammatory processes of the upper urinary tracts on the ground of urinary stone disease without destructive changes in kidney parenchyma leycocytes index of intoxication equaled 6,97±0,78 what corresponded to the upper margin of the average degree of painful illness of endogenous intoxication and the immune insufficiency response. After the treatment, which included the renovation of urine passage and adequate antibacterial therapy, leucocytes index of the intoxication equaled 1,37±0,24 which testified to the light degree of endogenous intoxication and positive condition of immune response.
3. In a group of the patients with obstructive pyelonephritis on the ground of urinary stone disease with the destruction of kidney parenchyma leucocytes intoxication index corresponded to a serious degree of endogenous intoxication which equaled 11,17±0,32 and decompensated immune response. After the treatment, which included minimally invasive drainage of destruction hotbeds and renovation of the urine passage, leucocytes intoxication index equaled 2,41±0,37 which corresponded to the average degree of endogenous intoxication and compensated insufficiency of the immune response.