Prediktivni značaj mijeloperoksidaze za nastanak postoperativnih vaskularnih komplikacija
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 kao i na njen prediktivni značaj za nastanak kardiovaskularnih insulta. Produkti delovanja mijeloperoksidaze predstavljaju inegrativni mehanizam koji povezuje lezije tkiva, infekcijski, inflamatorni proces, 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 sa 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 aktivisanja inflamatorne kaskade sa aktivisanjem ćelija mijeloidne loze pri čemu dolazi do oslobađanja i aktivisanja mijeloperoksidaze koja pored antimikrobnog ispoljava mnogostruka vaskularna delovanja. Povećana koncentracija mijeloperoksidaze u plazmi i do tri meseca pre kliničke ekspresije vaskularnog insulta ukazuje na njen prediktivni značaj. Aktuelna istraživanja predočavaju na mogućnost uspešnog korigovanja posledica delovanja mijeloperoksidaze i prevenciju vaskularnih komplikacija
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