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28.05.2014, 17:33 | |
Резюме УДК 616.441-006.5-06:616.34-002-036-08 Буковинський державний медичний університет (Чернівці) Bukovinian State Medical University 58002, Chernivtsi, Theatre Square. 2 Буковинский государственный медицинский университет 58002, г. Черновцы, Театральна пл., 2 ipolyanskaya@ukr.net Clinical experience and numerous scientific studies of recent years indicate a significant increase of thyroid disease frequency, including toxic forms of goiter (TGF). Excess thyroid hormones adversely affect almost all organs and systems, especially digestive system. Functional disorders of the gut occur in about 60% of patients with TGF and often persist even after effective thyreostatic therapy, transforming into irritable bowel syndrome (IBS). Research of oxidant-antyoxidant homeostasis and morpho-functional properties of erythrocytes poorly studied in patients with combination of TFG and IBS. The purpose of research was to analyze the efficacy of combined use of meteospasmil and carvedilol for correction of excessive activation of lipid peroxidation and oxidative modification of proteins, normalization of morpho-functional properties of erythrocytes in patients with TFG and IBS. Material and methods. Study involved 106 patients with TGF. All patients were examined, which included the collection of complaints, anamnesis, objective examination, laboratory and instrumental investigations. The diagnosis of thyrotoxicosis exhibited due to clinical, laboratory (level of TSH, free T3 and T4) and instrumental data. The diagnosis of IBS exhibited due to the Rome III criteria (2006). The parameters of lipid peroxidation (malonic aldehyde in erytrocytes and blood plasma), oxidative modification of proteins, antioxidant system (restored glutathione, glutathione-S-transferase, glutathione-peroxidase, catalase, ceruloplasmine, total antioxidant activity) and morpho-functional properties of erythrocytes were studied. All the patients were divided into 3 groups. The 1st group included 35 patients with TGF combined with IBS- diarrhea type, 2nd group - 34 patients with thyrotoxicosis and IBS with a predominance of constipation. 3rd group consisted of 37 patients with TGF without disorders of the digestive system. Control group involved 20 healthy persons. In addition to basic therapy patients of 1st and 2nd group received meteospasmyl in a dose 1 capsule 3 times a day and α, β-blocker carvedilol in a dose 12.5 mg 1 time per day. The study was conducted in dynamics: before and 12-14 days after the treatment. Results. The indices of lipid and protein peroxidation were increased and the parameters of antioxidant protection were decreased in patients with TFG. The oxidant-antyoxidant homeostasis had differences depended on type of intestine disorder.The highest level of lipid and protein peroxidation was in the 1st group, lower – in the patients of 2nd group, the lowest – in 3rd group. The lowest parameters of antioxidant system were in patients of 1st group. All the patients with thyrotoxicosis had disorders of viscosity of erythrocyte suspension and index of erythrocytes deformability, especially patients of 1st group. The use of meteospasmyl and carvedilolum led to restoration of oxidative-antioxidative balance in patients with thyrotoxicosis and IBS. The parameters of morpho-functional properties of erythrocytes after the treatment were almost normalized. Conclusion. The use of meteospasmyl and carvedilol in patients with toxic goiter forms and irritable bowel syndrome lead to reduction of peroxidation processes, increase of antioxidant protection, normalization of morpho-functional properties of erythrocytes. Література
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