THE DIAGNOSTIC SIGNIFICANCE OF CREATINE PHOSPHOKINASE IN THE DETECTION OF DESTRUCTIVE FORMS OF CHOLECYSTITIS IN PATIENTS OF THE OLDER AGE GROUP

Yashnov Alexey A., Yashnova Nadezhda B., Burtceva Mariya A., Konovalova Olga G., Hanina Julia S.

The diagnosis of destructive cholecystitis is a complex medical problem that requires an integrated approach. Despite the development of modern imaging techniques, the differential diagnosis of various forms of cholecystitis still causes considerable difficulties for specialists. Accurate and early identification of destructive changes in the gallbladder wall is crucial for determining treatment tactics and prognosis of the disease. Aims: to evaluate the role of changes in the concentration of the enzyme creatine phosphokinase autolysis as a predictor of acute destructive cholecystitis. Methods: During a retrospective one-stage study at Chita City Hospital No. 1, the condition of 180 patients with acute calculous cholecystitis was studied. The study group was divided into three main subgroups depending on the degree of inflammatory changes in the gallbladder wall: acute phlegmonous cholecystitis, acute gangrenous cholecystitis and acute catarrhal cholecystitis, each of which included 60 patients. The study is performed in the first 2 hours of hospitalization using the kinetic colorimetric method. The reagents CREATINE PHOSPHOKINASE - VITAL, manufactured in St. Petersburg, are used for the determination. The data was analyzed using SPSS Statistics 11.0. Results: the study showed significant differences in the concentration of CFRP in different forms of cholecystitis. In cases of gangrenous cholecystitis in patients over 70 years of age, the level of this enzyme reaches 343.3±49.2 U/l (p <0.001), with phlegmonous 295.5±29.8 U/l (p<0.001), and with catarrhal 117.59±44.3 (p=0.001). In patients over 70 years of age, there was also a direct and strong relationship between the concentration of CFRP and the severity of the disease, which is reflected in the index of 0.95 (p=0.001). Conclusions: when the gallbladder wall is destroyed, it is advisable to use creatine phosphokinase concentration as an indicator of damage.

Keywords:acute cholecystitis, diagnosis, destruction of the gallbladder wall, surgery.