Peripheral blood monocytogram and monocyte indices in elderly patients with chronic pyelonephritis

Chronic pyelonephritis is a nonspecific inflammatory process of predominantly bacterial nature, especially dangerous for elderly patients at risk. The monocytogram allows you to evaluate and compare the percentage of monocytes of different classes in peripheral blood in healthy people and patients with diagnosed pyelonephritis of different age groups, which can be used as an additional method of its diagnosis.

The research objective: to study the monocytogram and the values of monocyte indices of peripheral blood in elderly patients with chronic pyelonephritis.

Materials and research methods. Peripheral blood samples from healthy individuals and patients of three age groups with chronic pyelonephritis in the exacerbation stage were studied: 1 group – 18–44 years old, 2 group – 45–59 years old, 3 group – 60–74 years old. The monocytogram was studied, the blood leukocyte shift index, leukocyte intoxication index, neutrophil and monocyte ratio index, and lymphocyte and monocyte ratio index were calculated.

Research results. The absolute number of class 1 monocytes in the group of young and elderly patients is increased compared to the control (p < 0.05). The relative number of class 1 monocytes in all age groups does not change compared to healthy people. The absolute number of class 2 monocytes is higher in groups 1 and 3 compared to the group of healthy people (p < 0.05). The number of class 2 monocytes is increased in the group of young patients compared to the control (p < 0.05). The absolute number of class 3 monocytes is higher in groups 1 and 3 compared to healthy people and patients of group 2 (p < 0.05). The percentage of class 3 monocytes is lower in groups 1 and 2 compared to the control and patients of group 3 (p < 0.05). The shift index of blood leukocytes in the group of the elderly is higher than in the control (p < 0.05). The leukocyte intoxication index is higher than in the control in elderly patients (p < 0.05). The neutrophil to monocyte ratio is reduced in the group of young patients relative to the group of elderly patients (p < 0.05). The lymphocyte to monocyte ratio is reduced in all age groups relative to the control (p < 0.05).

Conclusion. Changes in monocyte indices reflect an increase in the proliferation of monocyte precursors in the bone marrow with an accelerated release of younger forms into the blood, indicate a decrease in the reactivity of the blood defense system in elderly patients with chronic pyelonephritis, along with a pronounced reaction of the monocyte-macrophage system in elderly and young patients. Integral indicators of the peripheral blood leukocytogram reflect the work of the effector mechanisms of the immune system, they indicate the preservation of protective compensatory-adaptive mechanisms in elderly people and a pronounced blood reaction to inflammation in a group of elderly patients with chronic pyelonephritis.

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