ENDOTOXEMIA IN CHRONIC PANCREATITIS IN COMORBIDITY WITH DIABETES MELLITUS AND POSSIBILITIES OF ITS CORRECTION BY LOW VOLUME INFUSION THERAPY
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i4.12804Keywords:
chronic pancreatitis, type 2 diabetes, endogenous metabolic intoxication, average mass molecules, Integral hematological indexes of intoxicationAbstract
SUMMARY. The article presents the results of the study of indicators of metabolic endogenous intoxication (mEI) – average mass molecules (AMM) and their correlation with integral hematological indexes of intoxication (iHII), their dynamics are researched on the background of the proposed scheme of small-volume infusion detoxification therapy (SVIDT) with hyperosmolar balanced crystalloid (HBC) ) during the period of 10 days with control of 3, 5 and 10 days.
The aim – to evaluate the therapeutic effect of MOIT on the severity of mEI syndrome in patients with HP in comorbidity with DM-2.
Material and Methods. 115 patients formed in 5 groups: 1st group – 20 patients without complaints from the gastrointestinal tract, 2nd group – 30 patients with HP, 3rd group – 20 patients with HP with concomitant DM-2, which received protocol therapy, 4th and 5th group – patients with HP with accompanying DM-2, of which 21 patients received protocol therapy with the inclusion of the course of MOIT for 3 days, and 24 patients – the MOIT course of 5 days.
The concentration of pools AMM -λ-254, AMM -λ-280, reactive response of the body to intoxication and severity of inflammation were determined. The statistical processing of the received data was carried out using Microsoft Excel 2016 and Statistica 13.0.
Results. A positive therapeutic effect on the dynamics of the level of mEI and iHII markers in patients with DM-2 is proved, which indicates a positive effect of the MOIT inclusion scheme in the program of integrated treatment. A clear dependence of the rate of normalization of defined indicators on the duration of the course of the MOIT is revealed.
Conclusions. 1. The statistically significant increase in objective mEI objective markers in patients with HP with concomitant DM-2 in comparison with such in isolation HP (p<0.05) was revealed.
- A medium strength correlation between MEI and IGi markers was determined, which objectively relies on the dynamics of IGi in assessing the effectiveness of therapy.
- A higher level of efficiency in the complex therapy of MOIT-5 is determined compared to the MOIT-3 program.
- It is proved that the normalization of the defined indicators directly correlates with the duration of the course.
References
Babinets, L.S. (2003). Analiz vplyvu riznykh etiolohichnykh chynnykiv na vynyknennia khronichnoho pankreatytu [Analysis of the influence of various etiological factors on the occurrence of chronic pancreatitis]. Visnyk Vinnytskoho derzhavnoho medychnoho universytetu – Reports Vinnytsia State Medical University, 7 (2/1), 444-445 [in Ukrainian].
Gromashevskaya, L.L. (1997). «Sredniye molekuly» kak odin iz pokazateley metabolicheskoy intoksikatsii v organizme ["Medium molecules" as one of the indicators of metabolic intoxication in the body]. Laboratornaya diagnostika – Laboratory Diagnostics, 11-16 [in Russian].
Gubergrits, N.B., & Khristich, T.M. (2013). Klinicheskaya pankreatologiya [Clinical pancreatology]. Donetsk: OOO «Lebed» [in Russian].
Mostovyi, Yu.M. (2017). Suchasni klasyfikatsii ta standarty likuvannia rozpovsyudzhenykh zakhvoriuvan vnutrishnikh orhaniv [Modern classifications and standards for the treatment of common diseases of the internal organs]. Vinnytsia [in Ukrainian].
Golias, Ch., Charalabopoulos, A., Stagikas, D., Charalabopoulos, K., & Batistatou, A. (2007). The kinin system – bradykinin: biological effects and clinical implications. Multiple role of the kinin system – bradykinin. Hippokratia, 11 (3), 124-128.
Schrader, H., Menge, B.A., Zeidler, C., Ritter, P.R., Tannapfel, A., Uhl, W., …, & Meier, J.J. (2010). Determinants of glucose control in patients with chronic pancrea titis. Diabetologia, 53, 1062-1069. DOI: https://doi.org/10.1007/s00125-010-1705-0.
Gubergrits, N.B., & Khristich, T.N. (2000). Klinicheskaya pankreatologiya [Clinical pancreatology]. Donetsk : Lebed [in Russian].
Halushko, O.A., & Nedashkivskyi, S.M. (2020). Intoksykatsiinyi syndrom v praktytsi likaria vnutrishnoi medytsyny: rol i mistse Reosorbilaktu [Intoxication syndrome in the practice of internal medicine: the role and place of Reosorbilaktu]. Novyny medytsyny ta farmatsii – News of Medicine and Pharmacy, 3(715), 14-16 [in Ukrainian].
Lomakina, Ye.Yu., Taratina, O.V., & Belousova, Ye.A. (2019). Khronicheskiy pankreatit i sakharnyy diabet: obzor literatury [Chronic pancreatitis and diabetes mellitus: a literature review]. Almanakh klinicheskoy meditsiny – Almanac of Clinical Medicine, 47(6), 525-534. DOI: 10.18786/2072-0505-2019-47-075.
(2014) Khronichnyi pankreatyt: adaptovana klinichna nastanova, zasnovana na dokazakh. 2014.2 [Chronic pancreatitis: an adapted clinical guideline based on evidence. 2014.2] Nakaz Ministerstva okhorony zdorovia Ukrainy vid 10.09.2014 № 638 – Order of the Ministry of Health of Ukraine from 10.09.2014 No. 638 [in Ukrainian].
ACG-2020. Clinical guidelines for the diagnosis and treatment of chronic pancreatitis: overview of key provisions in practice.
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