Clinical assessment of the adaptation of military personnel with shoulder injuries depending on the degree of stress response

Background. The degree of adaptation of the body depends on many factors, including its ability to adapt to certain factors that cause damage. After all, it is soldiers who are constantly exposed to physical and metabolic stress. Purpose: to perform a clinical assessment of the adaptation of the body in military personnel with shoulder injuries based on leukocyte index, blood biochemical indicators, and hemostasis system markers. Materials and methods. A survey of 34 military personnel was conducted, all of whom were male patients diagnosed with shoulder injuries. The average age of patients was 47.52 ± 12.25 years. All of them were divided into 4 groups according to the leukocyte index: group I — patients who showed a stress reaction (n = 5); group II — patients with a training reaction (n = 8); group III — patients who showed a calm activation reaction (n = 12); group IV — patients with an increased activation (n = 9). Stress was assessed according to the Mississippi scale, pain — according to the visual analogue scale. The following were examined in the patients’ blood: leukocytes — by counting in a Goryaev chamber, leukogram — in smears stained according to Romanowsky-Giemsa, erythrocyte sedimentation rate — by the Westergren method. The following biochemical markers were determined in blood serum: total protein — using the biuret method, glucose — using the enzymatic method, and a thymol test was performed. The content of fibrinogen, active partial thromboplastin time (APTT), prothrombin time (PT) and soluble fibrin-monomer complexes in blood plasma was determined using ready-made reagent Renam kits. Results. The most pronounced changes in the integral leukogram indicators, markers of coagulation, and liver enzyme activity were observed in patients with a stress response; less pronounced disturbances were detected in patients with a training response. The indicators for calm adaptation and increased activation reactions were the least altered, which is associated with compensatory mechanisms in the patients’ bodies. The most diagnostically significant in the study groups of patients with varying degrees of adaptation were leukocyte index of intoxication, fibrinogen level, APTT and PT, and in patients with acute stress reaction — alanine aminotransferase, aspartate aminotransferase and glucose activity. Conclusions. The laboratory results help us figure out what stage of stress response the patient is at and check out their ability to adapt based on the clinical assessment of biochemical tests and hemostasis markers.