INFLUENCE OF NOSOLOGIES COMORBIDITY OF THE DIGESTIVE SYSTEM ON THE CLINICAL COURSE OF PRIMARY OSTEOARTHRITIS AND FUNCTIONAL CAPACITY OF THE PANCREAS
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i3.12171Keywords:
primary osteoarthritis, exocrine insufficiency of the pancreasAbstract
A special pathogenetic link in the progression of primary osteoarthritis (OA) and gastrointestinal diseases accompanied by exocrine pancreatic insufficiency (EPI) is activating the kallikrein-kinin system, which plays an extremely important role in the regulation of vascular tone, diuresis, inflammation, coagulation, and pain reception.
The aim – to study the pathogenetic effects of the activation of the kallikrein-kinin system on the course of primary OA under conditions of comorbidity with gastrointestinal diseases.
Material and Methods. We examined 229 patients with primary OA in comorbidity with EPI of the pancreas in diseases of the gastrointestinal tract without exacerbation. Proteolytic activity of plasma, the activity of kallikrein, prekallikrein, the activity of a1-inhibitor of proteinases and a2-macroglobulin, activity of kininase-II were determined.
Results. The study of the kallikrein-kinin system revealed the highest activation of indicators in the group of patients with primary OA and chronic pancreatitis (CP) (p<0.05), statistically significantly weaker activation of the kallikrein-kinin system in the group of patients with comorbid hepatobiliary disorders (p<0.05), lower – when combining OA with chronic gastroduodenitis (p<0.05). In the group of patients with isolated OA, the weakest activation of the kallikrein-kinin system among the comparison groups (p<0.05).
According to the results of correlation-regression analysis, the highest statistically significant level of correlation between the level of fecal a-elastase and CC was found in the group of patients with comorbidity of primary OA and CP, statistically significantly lower in the group with combined hepatobiliary disorders, and the lowest in the group with concomitant chronic gastroduodenitis.
Conclusions. The study results proved a significant effect of kallikrein-kinin system activation on the course of primary OA under conditions of comorbidity with nosologies of the digestive system with EPI of the pancreas and on the deepening of functional insufficiency of the pancreas by fecal a-elastase.
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