CHARACTERISTICS OF REGULATORY INFLUENCES OF VEGETATIVE NERVOUS SYSTEM IN PATIENTS WITH GASTRIC AND DUODENAL ULCERS, DEPENDING ON AGE

O.A. KARPOVICH, T.N. YAKUBCHIK

Grodno State Medical University, Grodno, BELARUS

Introduction: So far, aspects of the pathogenesis of gastric and duodenal ulcer diseases (UD) in relation to the state of the tone of the vegetative nervous system (VNS), which, in spite of the established ideas about the prevalence of vagotonic effects may vary, has not been definitely clarified.

The aim of the study was to study characteristics of regulatory influences of the VNS in patients with UD, depending on age.

Materials and methods: We examined 70 patients with UD at the stage of exacerbation, at the age between 18 – 80 years (average age - 35 ± 16). The examined patients were divided into 2 groups: the 1^st group of patients aged between 18 to 40 years (n = 44), second - 41 years and older (n = 26). Conditions of the vegetative tone was assessed according to the results of spectral and temporal analysis of heart rate variability (HRV) on “Poly-spectrum” APK.

Results: During the study of the VNS at rest there was revealed a significant predominance of humoral-metabolic effects in the modulation of heart rate (p <0.005), with reduced level of vagal influences (p <0.05) in a group of persons at above 40 years. Vegetative tone of patients of the 1^st group was characterized by significantly higher total power spectrum of neurohormonal modulations (TP: 2137 (820,0;4225,5), 947,5 (474,0;1241,0); р<0,05). The balance of the segments of VNS is characterized by the dominated activity of the sympathetic segment of the nervous system in patients of the both groups, with more expressed of the domination in the second group (LF/HF 1,4 (0,8;2,5), 1,9 (0,8;3,2)). During the spectral analysis of VNS, there were revealed significant differences in levels of all components of the spectrum with a significant decrease in the indicators ​​of the low-frequency and high frequency components of the second group (p <0.05).

Conclusion: With years there occurs disintegration of the different levels of vegetative regulation. The data, obtained on the basis of short-term (5 min) record of cardiorhythmogram shows weakening of vegetative influences during aging. At the same time. parasympathetic influence weakens faster. As a result, relative domination of the sympathetic regulation against the overall reduction tone of the VNS is formed in older persons.

FEATURES OF CYTOPROTECTORS FOR GASTRITIS TREATMENT

N.M. KHOMERIKY

The hospital of RAS, Pushino Research Center, Pushino, RUSSIA

The problem currency. The chronic gastritis prevalence is 80% adults. One of main reasons of its origin is the NR infection when defects of the mucoepithelial barrier ensuring normal resistance of the mucous membrane exist. The mucoepithelial barrier damages make the mucous membrane unprotected before the aggression factors such as NR, hydrochloric acid, pepsin, NPVS. When gastritis is treated, along with removal of the reason of its origin, it is well to potentiate cytoprotective mechanisms.

Basic data. The stomach cytoprotection is executed due to the mucoepithelial barrier. The mucus excreted by the surface epithelium consists of two layers : one easily removable in the course of digestion, and attached one. This attached mucus gel consists of mucins, trefoil peptides (TFF) and phospholipids. The mucus and bicarbonates are pre-epithelial protection level. The cells excreting the mucus and bicarbonates are the protection factors at the level of the epithelium. The microcirculation race ensuring adequate blood supply for all processes plays the role of protection at the post epithelial level. The factors supporting the epithelial barrier include prostaglandins, nitric oxide, epidermal growth factor (EGF), a-transforming growth factor (TGF-a), trefoil peptides.

Application of pharmacomedicines with cytoprotective characteristics for treatment of gastritis of any aetiology enables to liquidate existing defects of the mucoepithelial barrier. The cytoprotective features of the bismuth salts, first of all, the dicitrate tripotassium bismuth (De-Noel) are known for a long time. The medicinal effect of this drug is conditioned to a large extent with its ability to stimulate synthesis of prostaglandins in the stomach, causing increase in the mucus and bicarbonate excretion, the mucous membrane bloodstream improvement, reduction of the cytokine products by the inflammatory infiltration cells, saves the , epidermal growth factor. Locally, De-Noel depresses the pepsin activity, bonds the bile acid salts at pH<4, generates precipitates which are adhered on the mucous coat of the stomach in the places of the epithelium damages, promotes the recovery of the mucus thickness and viscosity. The drug is effective for NR elimination in the schemes of eradication.

Conclusion : cytoprotective characteristics of the dicitrate tripotassium bismuth (De-Noel) enable to use it at any types of the chronic gastritis and at any stage of the course of the disease.

Date: 2014-12-28; view: 1010