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11.08.2014, 18:11 | |
Резюме Рецензент: д.мед.н., проф. Ю.Г. Бурмак УДК 616.342 – 002.44+616.12 ДЗ «Луганський державний медичний університет» ГЗ «Луганский государственный медицинский университет» State Establishment "Lugansk State Medical University" Центральна міська клінічна лікарня №1 (Донецьк) Центральная городская клиническая больница №1 (Донецк) Central Clinical Hospital №1 (Donetsk) propedevtika2011@yandex.ua, siderman@ukr.net, mishadoctor@ukr.net The incidence of peptic ulcer of the duodenum (PUD), which annually occurs in 0.2% of the population of Ukraine amounts to 28.8% of the total number of chronic diseases of digestive organs. At the same time cardiovascular diseases take the first place on prevalence, and mortality from, including coronary heart disease (CHD), exceeds similar indicators in other countries of Europe. Several studies have shown significant relationship between the presence of chronic infection caused Helicobacter (HP), the development of atherosclerotic lesions of blood vessels and the heart. Today there is a growth polymorbidity patients, including combined flow PUD and coronary heart disease (8-14%), modifies the clinical picture of both diseases, complicates the diagnosis reduces the effect of treatment. The aim of the study was to examine changes in the cellular link of immunity in patients with PUD in combination with coronary artery disease and the effectiveness of exposure to combinations of subalin and tivortin aspartate. Was studied 120 patients PUD in combination with coronary heart disease, including 87 men (72.5%) and 33 women (27.5%) in the age from 23 up to 63 years. The control group consisted of 30 healthy persons (11 women and 19 men). The examined patients were divided into two randomized groups: primary (69 people) and comparison (51 people). All patients received standard therapy PUD and coronary heart disease. Patients of the main group in the course of treatment was additionally appointed combination registered in Ukraine drugs subalin and tivortin aspartate. Before treatment in both groups surveyed found considerable changes of the cellular levels of immunity, which was characterized by T-lymphopenia and imbalance subpopulation composition of the T-cells primarily due to the reduction of the number of circulating T-helpers/inductors (CD4+), which was confirmed by the decrease of the immunoregulatory index of CD4/CD8 (Th/Ts) and testified to the presence of secondary immunodeficiency states. It was also observed a significant decrease in the response of lymphocytes blasttransformation, testified to the inhibition of functional activity of T - lymphocytes. The number of T-suppressors (CD8+) was moderately corresponded to the lower limit of the norm. The number of b cells (CD22+) most patients was within norm. In the main panel prior to treatment, the number of CD3+cells was reduced by 1.4 and 1.3 times, respectively, to normal. After completion of treatment in patients of main group, which in addition to the traditional treatment used a combination of subalin and tivortin aspartate, noted positive dynamics of the immunological parameters, namely the liquidation T-lymphopenia, normalization of T-helper cells, namely the increase in CD4+cells. The number of CD8+cells was increased relative to the original value, and was close to the upper limit of normal. Immunoregulatory index of CD4/CD8 increased in 1,3 times and was close to normal In the group mappings after conventional therapy had positive dynamics is studied immunological parameters, however, considerably less pronounced than in patients of main group. So, the patients of group mappings remained limfopenia and imbalance subpopulation composition of lymphocytes: the number of T-lymphocytes was 1.2 times less than the norm; CD-4+-lymphocytes, or 1.6 times less than the norm; CD 8+cells - 21.1 minus 1.2%, i.e. by 1.1 times less than the norm. We also observed a decrease of the immunoregulatory index relative to normal values in 1,2 times. The number CD22+-lymphocytes was 1.03 times less than the normal rate the response of lymphocytes blasttransformation was less compared to normal values in 1.8 times. Conclusions 1. In patients with PUD in combination with coronary heart disease were observed T-lymphopenia, imbalance major subpopulations of T-cells with the reduction of the immunoregulatory index of CD4/CD8. 2. The inclusion of a combination of subalin and tivortin aspartate in the complex treatment of patients in conditions polymorbidity PUD and coronary heart disease helped dispose of T-lymphopenia, normalization subpopulation composition of T-lymphocytes. 3. Further research is the study of other parts of the immune response in patients with polymorbidity.
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