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тезисы 15-го юбилейного съезда ногр... | abstracts 15th anniversary congress "gssr".
The results. Before treatment in all groups were observed persistent violations of the stool. In this case, 68 % of patients for the treatment oflong-term take drugs senna, 15 % used a diet therapy, 15 % used candles and enemas, the remaining 2 % were not treated. The therapy after 2 weeks in patients 1st and 2nd group 65 % showed normalization ofstool. Among patients treated with lactulose only by the end of the 2nd week of the number of cases normalization of stool reached 45 %. By the end of the 4th week
among patients ofthe 1st and 2nd groups, the incidence of normalization ofstool reached 76 %, while among patients treated with lactulose — 65 %. When analyzing the results of SF-36 in patients on therapy trimebutin observed a significant improvement in quality of life compared with patients receiving monotherapy lactulose.
Conclusions. Using trimebutin in the treatment of chronic constipation in stroke patients with diabetes, leads to a better quality oflife, faster recovery ofbowel function.
113. Analysis of proton pomp inhibitors efficacy in prevention of erosive damages of stomach after endoprosthesis replacement operation at H. pylori infected patients who take NSAIDs
Edemskaya M. A., Pakhomova I.G., Baryshnikova N. B., Belousova L. N.
NWSMU n.a. I.I. Mechnikov, FSPbSMY n.a. I. P. Pavlov, Saint-Petersburg, Russia
The aim: to study efficacy of proton pomp inhibitors (PPI) in prevention of erosive damages of a stomach in the postoperative period at H.pylori infected patients with damage of the large joints who take NSAIDs.
Materials and methods. 129 H.pylori infected patients with damage ofthe coxofemoral and knee joints needing endoprosthesis replacement and taking NSAIDs at least once a week, not less, than within 2 weeks before hospitalization were surveyed. Before operation and in 10-14 days after operation all patient completed the survey for the analysis ofabdominal pain and gastroscopy was made at the same dates. Before treatment according to gastroscopy results patients had no erosive changes in stomach. Patients were divided into 2 groups: the 1st — the patients
preventively taking omeprasol before and after operation 20 mg once a day (66 people); the 2nd — group of comparison without preventive therapy of PPI (63 persons).
Results. Abdominal pain before operation was in 29.5 % of patients in the 1st group and 30,5 % in the 2nd group; after treatment in 8,8 % in the 1st group and 31,4 % in the 2nd group. Erosions of a mucous of stomach after operation were at 3 % of patients in the 1st group and at 17,5 % — in the 2nd group.
Conclusions. Suppression of a gastric acidity in the postoperative period is an effective method of prevention of development of NSAIDs-associated damages of a stomach at H.pylori infected patients with diseases of the large joints needing endoprosthesis replacement.
114. The endotoxin aggression in children with erosive and ulcerative diseases of the duodenum, associated with H. pylori and small intestinal bacterial overgrowth syndrome
Guz N. P., Nalyotov A. V.
Donetsk National Medical University named after M. Gorky, Medical centre «Gastro-line», Donetsk, Ukraine, e-mail: nalyotov-a@mail. ru, gastrodoc@mail.ru
The aim. The purpose ofthis study was to determine the level of systemic endotoxemia in children with erosive and ulcerative processes of the duodenum, associated with H.pylori and small intestinal bacterial overgrowth syndrome (SIBO).
Material and methods. 60 children, aged 12 to 17 years, all with H.pylori-associated erosive and ulcerative duodenal diseases were included in the study: 20 patients with peptic duodenal ulcer (DU) and 40 patients with duodenal erosion (DE). The SIBO was determined in all patients. The concentration of lipo-polysaccharide (LPS) of Gram-negative bacteria was studied in all children. The diagnosis of H.pylori was carried out by two methods: the rapid urease test with biopsy and the urea breath test using the test system «Helic» with detector tubes («AMA», Russia). The SIBO was diagnosed by using the hydrogen breath test with lactulose load and using the digital analyzer of exhaled
hydrogen «LaktofaH2» («AMA», Russia). The control group consisted of 20 healthy children.
Results. The level of LPS in patients with H.pylo-ri-associated ulcerative and erosive gastroduodenal pathology significantly exceeded (p<0.05), this data in healthy children (0.52±0.04) EU/ml. The highest level of LPS is estimated in children with DU (2.1±0.1) EU/ ml. Among patients with DE it was (1.9±0.1) EU/ml. All children of the control group had endotoxinemia within the physiological range, which did not exceed 1.0 EU/ml. Physiological endotoxinemia were detected in only 2 — (10.0±6.7)% patients with DU and in 5 (12.5±5.2)% patients with DE.
Conclusion. Thus, H.pylori-associated erosive and ulcerative duodenal diseases in children occur on the background of SIBO. These microbial disturbances are accompanied by increased serum level of LPS of Gram-negative bacteria.
115. Risk of developing NSAID-gastropathy in elderly patients suffering from cardiovascular disease in combination with diabetes
Koroleva L. Yu., Bukreeva M. V., Turchina M. S.
Orel state University, Russia, e-mail: lilechka2004@bk.ru
Objective: to study the probability of developing therapy in elderly patients suffering from cardiovascu-NSAID-gastropathy on the background of antiplatelet lar disease in combination with diabetes.
экспериментальная и клиническая гастроэнтерология | выпуск 117 | № 5 2015
информация | information
Materials and methods. A survey was conducted in 34 patients aged from 57 to 65 years old, suffering from cardiovascular disease in combination with diabetes, constantly receiving antiplatelet agents. The control group included 30 people ranging in age from 56 to 67 years, with diseases of the cardiovascular system without diabetes. From the study were excluded patients with complicated peptic ulcer history, as well as individuals receiving NSAIDs concerning other diseases.
Results. When performing gastroscopy in patients of the 1st group in 22 % of cases had erosive lesions of the mucous membrane of the upper parts of the gastrointestinal tract, while in the control group of such patients was only 12 %. All patients with symptoms of NSAID gastropathy was administered pantoprazole
at a dose of 40 mg/day for 14 days, followed by a control gastroscopy. As a result among the patients of the control group, there was complete restoration of the integrity of the gastric mucosa, whereas among the patients ofthe 1st group healing erosions occurred in 77 % of cases. In the future, these patients was prolonged course of pantoprazole in the same dose for 14 days. The follow-up gastroscopy were observed complete healing of erosions.
The conclusions. In patients with pathology of the cardiovascular system in combination with diabetes mellitus therapy with antiplatelet agents is more likely to occur erosive lesion of the mucous membrane of the upper parts of the gastrointestinal tract. For the treatment of such patients requires a longer course of antisecretory drugs.
116. Features of non alcoholic fatty liver disease at patients of advanced age
Krivosheev A. B., Kondratova M. A., Rybina O. V., Bogoryanova P. A., Tuguleva T. A.
NSMU, Novosibirsk, Russia, e-mail: krivosheev-ab@narod.ru
Objective: to estimate in the comparative plan of feature of a clinical course of non alcoholic fatty liver disease (NAFLD) at patients of advanced age.
Materials and Methods. 29 elderly persons aged from 60 to 77 years (the 1-st group) and 84 patients of middle age from 45 to 59 years (the 2-nd group) are examined. Complex examination is conducted.
Results. 1. Separately IHD was registered with an identical frequency of both groups. 2. Separately AG mainly was found in patients of the 2-nd group (7 times more often at men and is 2.5 times more often at women). 3. The combination of IHD and AG 2.5 times more often was registered at patients of the 1-st group. Pathology of bodies of digestion mainly came to light at patients of the 2-nd group. Frustration of a carbohydrate exchange were found in patients of the 2-nd group 3 times more often) more often. At all patients
the excess body weight and abdominal type of obesity took place. Diabetes of type 2 was mainly observed at patients of the 2-nd group (3 times more often at women). At patients ofthe 2-nd group the giperinsulinemiya appeared more significant and significantly exceeded norm, and also it was authentically above (p<0.05) in comparison with the 1st group. The HOMA-IR index was also much higher at patients of the 2-nd group, respectively 4,92±0,62 and 5,94±0,89. Frustration of a lipidic exchange had no basic distinctions at patients of both groups.
Conclusion. At patients of the 1-st group the ko-morbidnost is observed. At patients of the 2-nd group frustration of a carbohydrate exchange dominated, the insulinorezistentnost was more significant that is a pathogenetic basis of formation and progressing of NAFLD.
117. Liver injury in patients with metabolic syndrome
Larina N. A., Dudanova O. P., Tsekhanovich K. B.
Petrozavodsk State University, Russia, e-mail: Larina@okb10.ru
Objective: to estimate the frequency and character of liver injury in patients with metabolic syndrome.
Materials and methods. One hundred and forty seven patients with MS were enrolled. Liver functional status was assessed by laboratory tests (ALAT level, AST level, bilirubin, albumin, alkaline phosphatase, cholesterol), its structural state — by ultrasonic examination (U/S) and in 10 patients (6.8 %) — by histological investigation.
Results. All patients (100 %) had symptoms of NAFLD: 94 patients (63.9 %) had hepatic steatosis (HS), 53 patients (36.1 %) — steatohepatitis (SH), including 41 patients (77.4 %) with low activity (LA) of SH, 6 (11.3 %) — with moderate activity (MA) and 6 patients (11.3 %) — with high activity (HA). HS was characterized by increase of liver size and its echogenicity during U/S, while SH was characterized by cytolitic syndrome and histological activity. ALAT level in case of LA was (44.7±11.3) U/l, in case of MA — (100.6±31.9) U/l
(p<0.05) and in case of HA — (166.5±70.1) U/l (p>0.05), respectively. In case of SH of LA and MA there were signs of cholestasis: ALP was (329.5±188.3) U/l and (354.6±98.7) U/l; cholesterol was (6.5±1.1) mmol/l and (7.8±1.0) mmol/l (p<0.05) respectively. Protein synthetic and pigmentary functions ofliver did not change significantly. Dyslipidemia was increasing along with increasing SH activity, increase of TGs level was particularly pronounced: (3.44±1.68) mmol/l; (8.0±4.3) mmol/l (p<0.05) and (7.3±7.9) mmol/l respectively. According to U/S results, the size of the right lobe of liver closely correlated with the waist circumference: r=0.7 (p<0.02) and with BMI — r=0.6 (p<0.05).
Conclusions: All patients with MS had signs of NAFLD: 63.4 % patients had signs of steatosis, 36.1 % — signs of steatohepatitis, mainly of low activity (77.4 %). Dyslipidemia was characterized by pronounced tri-glyceridemia. Physical markers of MS correlated with the size of the right lobe of liver.
