Features of the Dynamics of the Peripheral Blood Lymphocytes during the First Week in Combined Radiation-Mechanical Lesions

For a long time, the attention of researchers studying combined radiation-mechanical injuries (CRMI) has been focused on the study of individual syndromes: mechanical trauma and acute radiation syndrome. To diagnose and assess the severity of each syndrome, tests used for isolated injuries are recommended. However, the results of tests based on counting the number of different peripheral blood cells in an initially healthy person and in an injured patient who has experienced severe bleeding will be different. Accordingly, the assessment of the severity of developing acute radiation disease these patients will differ.

The possibility of predicting the severity of developing radiation injury in CRMI using a lymphatic test during the first week after exposure is also being evaluated. In this report, based on the literature data, the dynamics of the absolute number of lymphocytes in patients with multiple mechanical injuries is considered.

The results of numerous clinical and experimental studies indicate that severe and multiple injuries, starting from the first hours and during the first week of observation, are characterized by instability of the number of lymphocytes in peripheral blood with significant absolute lymphopenia on the first day. It is shown that the depth of lymphopenia and the rate of recovery of the number of lymphocytes to normal values depends on the severity of the mechanical injury. In addition, the deepening of lymphopenia is also caused by urgent medical measures that are standard in the provision of medical care for severe trauma with blood loss: massive infusion therapy and the appointment of corticosteroids.

Thus, the use of a lymphocytic test in CRMI to assess the radiation dose without taking into account the significance of the trauma suffered will lead to a false prognosis of the degree of developing acute radiation damage, as well as to the lack of differentiation between the effects of radiation and non-radiation factors, and, consequently, to errors in patient management tactics.