Вміст фактора некрозу пухлин α і трансформуючого фактора росту β1 у сироватці крові хворих на гострий апендицит та абдомінальний туберкульоз

. Differential diagnosis of acute appendicitis with abdominal tuberculosis is аn urgent problem of medicine. Тhe immune system is involved іn the pathogenesis of diseases, and cytokines are the regulators of inflammation.The aim of the study – to determine the level of cytokines with the pro- and anti-inflammatory potential of TNFα and TGFβ1 and their correlation in the blood of patients with acute appendicitis and abdominal tuberculosis in order to improve diagnosis and treatment tactics. Research Methods. 51 patients with urgent abdominal pathology were examined, 21 of them with phlegmonous form of acute appendicitis, 30 patients with histologically confirmed diagnosis of abdominal tuberculosis. The content of TNFα и ТGFβ1 in serum was examined by the ELISA method by the reagents “Diaclone” and “DRG Diagnostic”.Results and Discussion. The results of studies have shown that the development of acute and chronic inflammatory process in the abdominal cavity is determined by activation of the macrophage-monocytic system, manifested by a significant increase in the serum level of TNFα. It was established that in patients with abdominal tuberculosis on the background of increased serum level of TNFα ((17.57±1.05) vs. (4.97±0.18) pg/ml) the TGFβ1 level does not differ from the control ((16.52±1.15) vs. (17.94±0.71) ng/ml) at that time, as with acute appendicitis, its level decreased ((11.32±0.65) vs. (17.94±0.71) ng/ml). ТGFβ1/TNFα ratio during the abdominal inflammation was much lower than control, but in abdominal tuberculosis in 1.5 times higher than in acute appendicitis.Conclusions. The serum level and ratio of monocyte-macrofage derived TNFα and ТGFβ1 determines the type of inflammation and may be useful in differential diagnostic of acute appendicitis and abdominal tuberculosis.