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Improvement of quality of life indicators in patients with metabolic syndrome after correction of hemodynamically significant coronary stenoses and dyslipidemia 纠正血流动力学显著性冠状动脉狭窄和血脂异常后,改善代谢综合征患者的生活质量指标
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-37-43
Y. Vukolova, I. V. Gubareva, O. Germanova, N. V. Savelyeva, A. V. Pashentseva
It is known that metabolic syndrome is currently the leading cause of the development of cardiovascular pathology, which occupies a leading position in the structure of mortality not only in the Russian population, but also in the world. The prevalence of MS is growing, which is associated with stressful professions, eating disorders. The presence of MS is associated with arterial hypertension and atherosclerosis of the arteries of any localization. In this regard, the purpose of our study was to study the quality of life in patients with MS, depending on the severity of coronary atherosclerosis. Materials and methods: The study included 239 patients (142 men, 97 women) with MS with atherosclerosis of the coronary and carotid arteries. The number of subjects in group 1 (n=141), of which 101 were men and 40 were women. The second group consisted of 84 male and 14 female patients (n=98). The control group consisted of 70 people (27 men, 43 women) with grade 1-3 hypertension. The age of the subjects was 31-56 years. All patients underwent: collection of complaints and anamnesis, assessment of body mass index (BMI); determination of the lipid spectrum, blood glucose, glycated hemoglobin. Microalbuminuria and glomerular filtration rate were determined. Instrumental studies were carried out: ultrasound examination of brachiocephalic vessels with determination of the thickness of the intima-media complex and the percentage of carotid artery stenosis; coronary angiography on the General Electric Innova 3100 angiographic complex. Based on the results of coronary angiography, the patients were divided into two subgroups: group 1 - with coronary artery stenosis of less than 50% (n=141), group 2 - with stenosis of 50% or more (n=98), group 3 (control) without stenotic lesions of the coronary arteries. A non-specific questionnaire “SF-36 Health Status Survey” was used to assess the quality of life. Results: assessing physical functioning and mental health, there was a significant decrease in these indicators in patients of group 2, in whom, according to coronary angiography, hemodynamically significant coronary artery stenoses were diagnosed, a strong correlation (r=0.730; p=0.005) was revealed between deterioration in quality of life and hemodynamically significant stenosis of the carotid and coronary arteries. Restriction of physical activity and reduction of daily activities were more significant in group 2 compared to groups 1 and 3. The feeling of uncertainty with restless expectation and fears, as well as a feeling of depression prevailed in men. However, patients after percutaneous coronary intervention, as well as with lipidogram correction, assessed the quality of life with some restriction of physical activity, but with significant social functioning. Conclusions: hemodynamically significant atherosclerosis of the carotid and coronary arteries is a predictor of deterioration in the quality of life, especially in men. The use of the international que
众所周知,代谢综合征是目前导致心血管病变的主要原因,不仅在俄罗斯人口中,而且在全世界的死亡率结构中都占据主导地位。多发性硬化症的发病率越来越高,这与职业压力大、饮食失调有关。多发性硬化症与动脉高血压和任何部位的动脉粥样硬化有关。因此,我们的研究旨在根据冠状动脉粥样硬化的严重程度,研究多发性硬化症患者的生活质量。材料和方法:研究对象包括 239 名患有冠状动脉和颈动脉粥样硬化的多发性硬化症患者(男性 142 人,女性 97 人)。第一组受试者人数(n=141),其中男性 101 人,女性 40 人。第二组包括 84 名男性患者和 14 名女性患者(n=98)。对照组包括 70 名 1-3 级高血压患者(男性 27 人,女性 43 人)。受试者的年龄为 31-56 岁。所有患者都接受了以下检查:收集主诉和病史,评估体重指数(BMI);测定血脂谱、血糖、糖化血红蛋白。还测定了微量白蛋白尿和肾小球滤过率。进行了仪器检查:肱动脉血管超声波检查,确定内膜-中膜复合体的厚度和颈动脉狭窄的百分比;使用通用电气公司的 Innova 3100 血管造影机进行冠状动脉造影。根据冠状动脉造影的结果,患者被分为两个亚组:第1组--冠状动脉狭窄小于50%(141人),第2组--狭窄50%或以上(98人),第3组(对照组)冠状动脉无狭窄病变。采用非特异性问卷 "SF-36 健康状况调查 "来评估生活质量。结果:在评估身体功能和心理健康方面,第 2 组患者的这些指标显著下降,根据冠状动脉造影术,这些患者被诊断为血流动力学意义上的冠状动脉狭窄,生活质量的恶化与血流动力学意义上的颈动脉和冠状动脉狭窄之间有很强的相关性(r=0.730;p=0.005)。与第 1 组和第 3 组相比,第 2 组患者限制体力活动和减少日常活动的情况更为显著。男性患者普遍存在不确定感、不安的预期和恐惧感以及抑郁感。然而,经皮冠状动脉介入治疗后的患者以及经过血脂检查纠正的患者对生活质量的评价是,身体活动受到一定限制,但社会功能明显提高。结论:血液动力学上明显的颈动脉和冠状动脉粥样硬化是生活质量恶化的预兆,尤其是男性。使用国际问卷 "SF-36 健康状况调查 "来评估伴有动脉粥样硬化迹象的多发性硬化症和高血压患者的健康和生命活动是合适的。心脏科医生、内分泌科医生和心理治疗师的共同参与,有助于对合并病症的患者进行最佳管理。
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引用次数: 0
Sarcopenia and non-alcoholic fatty liver disease 肌肉疏松症与非酒精性脂肪肝
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-120-130
R. Myazin
The literature review examines the role of nutrition in the development of skeletal muscles. The pathogenesis of the development of sarcopenia and modern aspects of its diagnosis are outlined. Possible options for the influence of drugs on the state of skeletal muscles and its functional activity are presented. The relationship between sarcopenia and non-alcoholic fatty liver disease with proposed approaches to the treatment of these comorbid diseases is considered.
文献综述探讨了营养在骨骼肌发育中的作用。概述了肌肉疏松症的发病机理和现代诊断方法。介绍了药物对骨骼肌状态及其功能活动影响的可能选择。此外,还探讨了肌肉疏松症与非酒精性脂肪肝之间的关系,并提出了治疗这些合并症的方法。
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引用次数: 0
Hyperuricemia, gout and digestive system pathology: common links of pathogenesis 高尿酸血症、痛风和消化系统病理学:发病机制的共同联系
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-219-11-130-137
N. A. Konyshko, T. Morozova, V. V. Tsurko, G. S. Konyshko
The aim: to study and present scientists opinions on the direct and indirect clinical and pathogenetic purine compounds metabolism relationships with the digestive system physiological and pathological processes in normal uric acid levels conditions and in hyperuricemia and gout cases. Material and methods. A comprehensive analysis of available modern scientific official sources and regulatory documents for the last decade in the Scopus, PubMed.com, E-library databases. Conclusion. Based on the modern scientific literature data and numerous studies, we can say that there is a pathogenetic relationship between the level of uric acid and the digestive organs defeat.
目的:研究尿酸水平正常、高尿酸血症和痛风病例中嘌呤化合物代谢与消化系统生理和病理过程的直接和间接临床和致病关系,并提出科学家的观点。材料和方法。对 Scopus、PubMed.com 和 E-library 数据库中过去十年可用的现代科学官方来源和规范性文件进行了全面分析。结论。根据现代科学文献数据和大量研究,我们可以说,尿酸水平与消化器官败坏之间存在病理关系。
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引用次数: 0
Eosinophilic esophagitis and comorbid pathology: current state of the problem 嗜酸性粒细胞食管炎和合并病症:问题的现状
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-219-11-138-145
I. V. Zaikova-Khelimskaya, M. Y. Bank, A. A. Khelimskiy
Eosinophilic esophagitis and asthma are often found as part of comorbid pathology in children and adults, along with other manifestations of atopy. The two diseases share similar pathophysiology due to T-helper type 2 responses, common treatment approaches such as the use of glucocorticosteroids and targeted anti-cytokine biologic therapy. Patients with eosinophilic esophagitis, as with asthma, often have elevated serum markers of atopy, including IgE levels, peripheral eosinophil counts, and T-helper type 2-associated cytokines. A review of the literature shows that the true incidence of eosinophilic esophagitis remains poorly understood due to the difficulty of diagnosing this pathology, which has a mask of gastroesophageal reflux disease. Gastroesophageal reflux disease has been shown to influence asthma through microaspiration, airway hyperresponsiveness, and increased vagal tone. Understanding the relationship between gastroesophageal reflux and eosinophilic esophagitis is also being actively explored. Many works show the high efficacy of PPIs in the initial treatment of eosinophilic esophagitis and gastroesophageal reflux disease. The development of new clinical diagnostic criteria for eosinophilic esophagitis will improve the differential diagnosis of this disease and the improvement of therapeutic strategies for managing this pathology, especially in combination with asthma.
嗜酸性粒细胞食管炎和哮喘通常是儿童和成人合并病症的一部分,同时还伴有其他过敏表现。这两种疾病的病理生理学相似,都是由于 T 辅助细胞 2 型反应、糖皮质激素的使用和靶向抗细胞因子生物疗法等常见治疗方法所致。嗜酸性粒细胞食管炎患者和哮喘患者一样,血清中的特应性标记物通常会升高,包括 IgE 水平、外周嗜酸性粒细胞计数和 T 辅助细胞因子 2 型相关细胞因子。文献综述显示,嗜酸性粒细胞食管炎的真实发病率仍不为人所知,这是因为诊断这种病理现象十分困难,它有胃食管反流病的假象。事实证明,胃食管反流病可通过微量吸气、气道高反应性和迷走神经张力增强来影响哮喘。人们也在积极探索胃食管反流与嗜酸性粒细胞食管炎之间的关系。许多研究表明,PPIs 在初期治疗嗜酸性粒细胞食管炎和胃食管反流病方面疗效显著。嗜酸性粒细胞食管炎新临床诊断标准的制定将改善这种疾病的鉴别诊断,并改进治疗策略以控制这种病症,尤其是合并哮喘时。
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引用次数: 0
Insulin resistance, type 2 diabetes mellitus and sarcopenia 胰岛素抵抗、2 型糖尿病和肌肉疏松症
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-141-148
D. P. Kurmaev, S. Bulgakova, E. Treneva
Sarcopenia is a chronic age-associated disease, the prevalence of which increases with aging. The primary form is associated with aging, when no other causes have been identified, the cause of secondary sarcopenia may be various diseases, including type 2 diabetes mellitus (DM2). One of the common links in the pathogenesis of DM2 and sarcopenia is insulin resistance. A combination of sarcopenia and obesity is often observed. The interrelation of these pathological processes, etiology and pathogenesis are presented in this literature review.
肌肉疏松症是一种与年龄相关的慢性疾病,发病率随着年龄的增长而增加。原发性的肌肉疏松症与衰老有关,当没有找到其他原因时,继发性肌肉疏松症的原因可能是各种疾病,包括 2 型糖尿病(DM2)。DM2 和肌肉疏松症的共同发病机制之一是胰岛素抵抗。肌肉疏松症与肥胖症往往同时存在。本文献综述介绍了这些病理过程的相互关系、病因和发病机制。
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引用次数: 0
Polypill as a means of population pharmacological prevention of cardiovascular diseases 作为心血管疾病人群药物预防手段的多丸剂
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-64-74
P. A. Lebedev, I. K. Petruhina, E. V. Paranina
Non-communicable diseases, among which arterial hypertension and ischemic heart disease are the predominant contributors to disability and mortality, have long been identified as a strategic target of preventive intervention in our country. The situation is aggravated by covid-19 associated mortality, which is characterized by delayed dynamics and is largely related to cardiovascular. Excess mortality, in the structure of which cardiovascular diseases are leading, requires new solutions. One of them is population pharmacoprevention, based on the use of complex fixed combinations of drugs targeting different risk factors, as arterial hypertension and dyslipidemia, as most important. This concept, which logically follows from modern realities, is in contradiction with the existing approach of personalized therapy in high/very high risk groups, because of its complexity, leading to patients noncompliance. The new system of cardiovascular risk stratification SCORE 2 introduced in the Russian Federation significantly contributes to the spread of the concept of polypills as a unified approach primarily in the most vulnerable population of males 50 years and older.
非传染性疾病,其中动脉高血压和缺血性心脏病是导致残疾和死亡的主要因素,早已被确定为我国预防干预的战略目标。而 19 型冠心病相关死亡率则加剧了这一状况,其特点是动态延迟,主要与心血管有关。在死亡率过高的结构中,心血管疾病占主导地位,因此需要新的解决方案。其中之一就是人群药物预防,其基础是针对不同的危险因素,如最重要的动脉高血压和血脂异常,使用复杂的固定组合药物。从逻辑上讲,这一概念源于现代现实,但却与现有的针对高危/极高危人群的个性化治疗方法相矛盾,因为其复杂性导致患者不配合治疗。俄罗斯联邦引入的新的心血管风险分层系统 SCORE 2 极大地促进了多丸剂概念的传播,使其成为主要针对 50 岁及以上男性这一最脆弱人群的统一方法。
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引用次数: 0
Strategies for choosing combination therapy for hypertension in metabolic syndrome - focus on inflammation 选择联合疗法治疗代谢综合征高血压的策略--关注炎症
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-31-36
I. V. Gubareva, A. V. Pashentseva, Y. Vukolova, N. V. Savelyeva, L. Y. Shvan
The article substantiates the need for adequate fixed combination therapy for metabolic syndrome and arterial hypertension (AH). The issues of inflammation in the initiation and stabilization of arterial hypertension in patients with metabolic syndrome (MS) are considered. Taking into account the results of international and Russian studies, a differentiated approach is proposed to select a fixed combination of antihypertensive drugs for the treatment of hypertension and prevention of cardiovascular complications in patients with MS.
文章证实了对代谢综合征和动脉高血压(AH)进行适当的固定联合治疗的必要性。文章考虑了炎症在代谢综合征(MS)患者动脉高血压发病和稳定过程中的作用。考虑到国际和俄罗斯的研究结果,文章提出了一种区别对待的方法,以选择固定的降压药物组合来治疗代谢综合征患者的高血压和预防心血管并发症。
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引用次数: 0
Polycystic ovary syndrome and metabolic syndrome: possible ways to correct metabolic disorders 多囊卵巢综合征和代谢综合征:纠正代谢紊乱的可能方法
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-5-14
Y. Dolgikh, S. Bulgakova, L. A. Sharonova, E. Treneva, O. Kosareva, D. P. Kurmaev
Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. The prevalence of this pathology is approximately 15-20%. PCOS is characterized by hyperandrogenism, hirsutism, menstrual irregularities, and polycystic ovaries. More than half of patients with PCOS have a metabolic syndrome, the main component of which is visceral obesity and insulin resistance, which play an important role in the pathophysiology of PCOS. Insulin resistance is a marker of cardiometabolic risk and can lead to cardiovascular disease and carbohydrate metabolism disorders up to type 2 diabetes mellitus (DM2). Therefore, in the treatment of patients with PCOS, an important aspect is the impact on insulin sensitivity and body weight. This review focuses on various groups of drugs that can potentially have a positive effect on metabolic disorders in PCOS. Among them are metformin, drugs with an incretin effect, as well as drugs for weight loss. Given the similarity of the metabolic and pathological features of PCOS and DM2, as well as the diversity of therapeutic options, there is a potential for expanding the strategy for the treatment of metabolic disorders in PCOS, including through antidiabetic drugs, which, however, requires further study. It should be noted that surgical treatment of obesity also has a beneficial effect and contributes to the normalization of the menstrual cycle and the normalization of the hormonal and metabolic profile in patients with PCOS and severe obesity.
多囊卵巢综合征(PCOS)是育龄妇女常见的内分泌疾病。这种病的发病率约为 15-20%。多囊卵巢综合征的特点是雄激素过多、多毛、月经不调和多囊卵巢。半数以上的多囊卵巢综合征患者患有代谢综合征,其主要组成部分是内脏肥胖和胰岛素抵抗,这在多囊卵巢综合征的病理生理学中起着重要作用。胰岛素抵抗是心血管代谢风险的标志,可导致心血管疾病和碳水化合物代谢紊乱,直至 2 型糖尿病(DM2)。因此,在治疗多囊卵巢综合症患者时,一个重要的方面是对胰岛素敏感性和体重的影响。本综述将重点介绍可能对多囊卵巢综合症代谢紊乱产生积极影响的各类药物。其中包括二甲双胍、具有增量蛋白作用的药物以及减肥药物。鉴于多囊卵巢综合症和 DM2 在代谢和病理特征上的相似性,以及治疗方案的多样性,有可能扩大治疗多囊卵巢综合症代谢紊乱的策略,包括通过抗糖尿病药物,但这还需要进一步研究。值得注意的是,肥胖症的手术治疗也有好处,有助于使多囊卵巢综合症和严重肥胖症患者的月经周期正常化,激素和代谢状况正常化。
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引用次数: 0
Clinical improvement of some indicators of the activity of non-alcoholic fatty liver disease after correction of intestinal dysbiosis with dietary fiber 用膳食纤维纠正肠道菌群失调后,非酒精性脂肪肝某些活动指标的临床改善情况
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-222-2-44-49
I. A. Krylova, A. Lyamin, V. I. Kupaev
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引用次数: 0
The effect of the new coronavirus infection on the human pancreas 新型冠状病毒感染对人类胰腺的影响
Pub Date : 2024-03-26 DOI: 10.31146/1682-8658-ecg-219-11-153-159
S. V. Tarasenko, D. A. Glotov, O. D. Peskov, S. N. Sokolova, U. V. Zhuchkova, T. S. Rakhmaev, I. Bakonina, A. Bogomolov, D. O. Tyulenev, S. N. Brovkina, S. G. Bykova, S. V. Gurov
The aim of the study - is to study the effect of a new coronavirus infection on the human pancreas. Research materials. An analysis for blood α-amylase, as well as ultrasound of the abdominal cavity, namely the pancreas, was carried out. This study involved 20 patients, 10 had a concomitant disease in the form of diabetes mellitus and 10 without it. The results of the research. During the research, all patients had relatively the same dynamics of pancreatic lesions, without any pronounced manifestations of pancreatitis. The shift of analyses in favor of this pathology indicates more to the glucocorticosteroid therapy that patients received in the treatment of covid-19 coronavirus infection. Only one of the 20 patients studied had a classic manifestation of pancreatitis. Conclusions. Acute pancreatitis is a rare complication of COVID-19, and it is not often associated with this infection. Nevertheless, acute pancreatitis with SARS-CoV-2 infection is considered to have a higher risk of severe course and poor clinical outcomes, including the risk of organ dysfunction and higher inpatient mortality compared to patients with acute pancreatitis negative for SARS-CoV-2.
研究目的 - 研究新型冠状病毒感染对人类胰腺的影响。研究材料。对血液α-淀粉酶进行了分析,并对腹腔(即胰腺)进行了超声波检查。这项研究涉及 20 名患者,其中 10 人伴有糖尿病,10 人没有糖尿病。研究结果在研究过程中,所有患者的胰腺病变动态相对相同,没有任何明显的胰腺炎表现。分析结果更倾向于这种病理变化,这与患者在治疗柯维-19 冠状病毒感染时接受的糖皮质激素治疗有很大关系。在研究的 20 名患者中,只有一人有典型的胰腺炎表现。结论:急性胰腺炎是一种罕见的并发症。急性胰腺炎是COVID-19冠状病毒感染的罕见并发症,而且这种感染并不常见。然而,与 SARS-CoV-2 阴性的急性胰腺炎患者相比,感染 SARS-CoV-2 的急性胰腺炎患者出现严重病程和不良临床结果的风险更高,包括器官功能障碍的风险和更高的住院死亡率。
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引用次数: 0
期刊
Experimental and Clinical Gastroenterology
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