Моніторинг кореляційної залежності діагностичних маркерів гострого пієлонефриту та цукрового діабету в умовах експерименту

Acute pyelonephritis (АР) complicated by concomitant diabetes mellitus (DM) is often accompanied by the development of significant renal complications. In predicting its course and monitoring the effectiveness of drug treatment, attention is paid to the study of informative markers of the nature of the course of pyelonephritis – leukocyte index indicators and the level of pro-inflammatory eicosanoids, which allows determining the degree of intoxication in acute infectious-inflammatory process in the kidneys, making it possible to predict the nature of the development of the pathological process and assess the effectiveness of therapeutic measures. The objective: to investigate the relationship between АР and DM by monitoring their markers in an experiment. Materials and methods. Experimental studies were conducted on Wistar rats weighing 200–300 g at the age of 8–9 months, simulating АР and hyperglycemic condition, which by the nature of the course reproduces DM. The prototype of DM was induced by intraperitoneal injection of streptozotocin, during the period of stable hyperglycemia in animals, АР was simulated. Rats were given a single rectal injection of Escherichia coli isolate. On the second day, the animals were subjected to cold stress at a temperature of 0–2 °C for 2 hours. Bacteriological and general laboratory analysis of urine showed pronounced bacteriuria and a significant increase in the number of leukocytes per high power field in the groups of animals studied. 4 days after the start of the АР simulation, etiotropic drug exposure or etiotropic-pathogenetic drug exposure was applied. After the completion of drug exposure, peripheral blood from the tail vein was examined. The intensity of the inflammatory process and the degree of intoxication were determined based on the calculation of leukocyte integrative indices, which were calculated based on the leukocyte formula of peripheral blood. In peripheral blood smears, the leukocyte formula was determined. According to its indicators, integrative hematological indices were calculated, on the basis of which the following were determined: the degree of endogenous intoxication by the leukocyte intoxication index (LII). Determination of the level of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) in blood plasma was performed using the enzyme-linked immunosorbent assay method. The analysis of the content of eicosanoids in blood plasma was performed using selective antibodies of the test system for quantitative determination of the level of PGE2 and LTB4 by enzyme immunoassay on the Stat Fax 2100 analyzer (Awareness Technology, USA). Data on the correlation dependence between the level of LII in peripheral blood and the level of pro-inflammatory eicosanoids in kidney tissue (PGE2 and LTB4) are presented, as well as the influence of etiotropic and etiotropic-pathogenetic drug correction on the correlation dependence between the LII, pro-inflammatory eicosanoids and nephrospecific enzymes and proteins in АР and accompanying DM in an experiment. Results. The obtained results of study confirm the pathogenetic significance of the established correlation between LII, pro-inflammatory eicosanoids and nephrospecific metabolic indicators, which allows determining the severity of intoxication in the pathology under study and allows predicting the nature of the development of the pathological process, as well as evaluating the effectiveness of experimental therapy measures. The presence of a pronounced positive correlation with markers of the inflammatory process both in the case of АР and in its combination with concomitant hyperglycaemic state was established. A correlation between the level of LII in peripheral blood, creatinine clearance and the content of β2-microglobulin in urine was also determined in the case of АР and the accompanying hyperglycemic condition, taking into account etiotropic and etiotropic-pathogenetic drug effects. When evaluating the dependence between the level of LII and the activity of N-acetyl-β-D-glucosaminidase (N-AG), β-D-glucosidase in kidney tissue and taking into account the results of both types of drug exposure, we obtained a reliably significant negative correlation dependence of medium and strong relationship. Conclusions. The use of etiotropic medicinal effects caused a decrease in the correlation coefficient between indicators, a strong positive relationship between LII and the level of PGE2 and between LII and the level of LTB4 remained. When applying an etiotropic-pathogenetic drug effect in rats with АР and accompanying hypoglycemic state, the correlation coefficient between LII indicators and the level of PGE2 and between LII and the level of LTB4 decreased, which indicates the presence of an average positive relationship in terms of strength.