[Oxidative stress and leukocyte activation after lower limb revascularization surgery]

The authors aimed to study of oxidative stress and thrombocyte function in the perioperative interval following the revascularization surgery of lower limb. The prospective randomised study involved 10 patients whose surgical interventions were indicated by lower limb embolism, thrombosis or abdominal aorta aneurysm, and 10 healthy volunteers were also involved in the study. Peripheral blood samples were collected before, and after the surgery (2, 24 hours and one week). The maximal free radical production and lag time of the free radical production of activated leukocytes were measured, and leukocyte adhesion molecules (CD11a and CD18) signing leucocyte activation were determined as well. Endogenous antioxidant defence status, reduced glutathione (GSH), total thiol-groups (-SH), SOD activity and thrombocyte function were investigated in platelet rich plasma and in whole blood. White blood cell count and free radical production was significantly higher in patients group before surgery than in healthy group (in case of the free radical production the difference proved to be 10 times (p < 0.01)) and elevated continuously during the observation time. The CD11a and CD18 expression of the granulocytes significantly decreased right after the revascularization, but with a gradual elevation, until the 7th day they exceed the ischaemic value. GSH concentration decreased significantly 2 and 24 hours after surgery and total thiol groups (-SH) followed the same kinetics. SOD activity was significantly lower in patients group haemolysates before surgery when it was measured in healthy groups (p < 0.01) and decreased further significantly 24 hours after the surgery (p < 0.01 vs. before surgery). Suppressed thrombocyte aggregation was detected in platelet rich plasma and in whole blood during the observation excepted the one week samples, where a highly significant elevation in ADP and collagen induced aggregation were observed. Our results show a great alteration in the antioxidant-prooxidant balance and the insufficiency of platelet aggregation's inhibition after peripheral vessel closure and revascularization intervention. We suggest the monitoring of the antioxidant status and thrombocyte function of patients going to underwent surgical intervention and if it necessary the therapeutic help.