Indicators of Immune Status of Patients with Inflammatory Diseases of the Maxillofacial Area and Neck Depending on the Process Severity

Inflammatory processes of the maxillofacial area and neck are accompanied by the mobilization and activation of protection factors, both in the infection zone and in the organism on the whole, mechanisms of local and general resistance are involved. The purpose of the study was to analyze the changes in the immune status of patients with infectious diseases of the maxillofacial area and neck depending on the process of spreading. Material and methods. A comprehensive survey of 198 patients with maxillofacial infection was conducted in the department of maxillofacial surgery of the Vitebsk Regional Clinical Hospital from 2010 to 2018. The group of patients was divided into 4 subgroups: subgroup 1 (40 people) included patients with acute purulent odontogenic jaw periostitis, subgroup 2 (96 people) had patients with acute purulent odontogenic jaw osteomyelitis complicated by phlegmon of one cellular space, subgroup 3 (36 people) comprised patients with acute purulent odontogenic osteomyelitis of the jaw, complicated with phlegmon of 2-4 cellular spaces, and subgroup 4 (26 people) encompassed patients with acute purulent odontogenic osteomyelitis of the mandible, complicated with phlegmon of the mouth floor. A comprehensive assessment of the immune status was carried out on the basis of the results of the blood immunogram performed twice: on the first day and at the end of treatment. Results and discussion. There was an immune imbalance in the humoral link of immunity with an increase in the content of B-lymphocytes in patients with infectious and inflammatory diseases of the maxillofacial region, as well as the development of disimunoglobulinemia and a significant increase in the level of serum immunoglobulins of classes IgA, IgM, IgG. Along with this, there was a significant inhibition of the function of T-cell immunity, resulting in a decrease in the total number of T-lymphocytes (CD3+). Monocytes/macrophages, neutrophils, basophils, mast cells and eosinophils are of great importance during the infectious process. When comparing immunogram indices of patients with acute odontogenic infectious diseases of different spreading and healthy individuals, significant differences were found both at the beginning and at the end of treatment. Conclusions. At the same time, more evident deviations from the parameters of healthy people were noted in the subgroups of patients with more spread processes.