Abstract:
AIM:The goal is to evaluate the effectiveness of pancreatic enzyme replacement therapy (PERT) using microencapsulated pancreatin preparations for the correction of nutritional status in patients with chronic pancreatitis (CP) and associated exocrine pancreatic insufficiency (EPI). MATERIALS AND METHODS:The study included 58 patients with CP who were divided into two groups depending on the results of a laboratory assessment of indicators of nutritional status: group I (n=30) consisted of patients with CP and signs of EPI (according to low elastase test values) without deviations in nutritional status; Group II (n=28) consisted of patients with CP with a EPI and an abnormal nutritional status. In both groups, patients during the entire observation period (8-12 months) received PERT using microencapsulated pancreatin preparations at a dose adjusted for the severity of permanent residence permit. Before and after the PERT course, the dynamics of anthropometric [body weight, body mass index (BMI)] and laboratory indicators of nutritional status (total protein, albumin, vitamins D and B12, transferrin, iron and magnesium) were evaluated. RESULTS:After the completion of PERT, a significant tendency towards an increase in BMI in patients was noted in both groups. In group I, this indicator increased from 21.45 [95% confidence interval (CI) 19.80-23.92] kg/m2 to 22.15 (95% CI 20.31-23.86) kg/m2, and in II group - from 19.22 (95% CI 18.33-21.99) kg/m2 to 22.0 (95% CI 19.97-24.08) kg/m2. At the same time, the duration of PERT (months) significantly correlated with the dynamics of the patient's body weight (r=0.4679; 95% CI 0.2384-0.6479, p=0.0002). When assessing laboratory markers of nutritional status after PERT, a general tendency was found to increase the levels of total protein, albumin, vitamin D, magnesium, transferrin, and iron in both groups, however, statistically significant differences in the dynamics were observed mainly in group II patients. So, the level of total protein in group II increased from 69.05 (95% CI 65.6717-70.9000) g/l to 72.8 (95% CI 71.1358-74.9000) g/l, vitamin D - from 10.6 (95% CI 32.8397-38.9603) ng/ml to 17.1 (95% CI 12.0166-23.6232) ng/ml, magnesium - from 0.72 ( 95% CI 0.6892-0.7825) mmol/L to 0.795 (95% CI 0.7692-0.8800) mmol/L, and transferrin from 2.91 (95% CI 2.1800-3.3656 ) g/l to 2.92 (95% CI 2.4000-3.5200) g/l. CONCLUSION:A prospective observational study demonstrated the effectiveness of PERT using microencapsulated pancreatin preparations in the correction of nutritional status in patients with CP. :Цель - оценить эффективность заместительной ферментной терапии (ЗФТ) с использованием микрокапсулированных препаратов панкреатина при коррекции нутритивного статуса у пациентов с хроническим панкреатитом (ХП) и ассоциированной внешнесекреторной недостаточностью поджелудочной железы (ВНПЖ) в рамках проспективного наблюдательного исследования. Материалы и методы. В исследование включено 58 больных ХП, которых разделили на две группы в зависимости от результатов лабораторной оценки показателей нутритивного статуса: I группу (n=30) составили пациенты с ХП и признаками ВНПЖ (по данным низких значений эластазного теста) без отклонений в нутритивном статусе; II группу (n=28) составили больные ХП с ВНПЖ и аномальным нутритивным статусом. В обеих группах пациенты в течение всего времени наблюдения (8-12 мес) получали ЗФТ с использованием микрокапсулированных препаратов панкреатина в дозе, скорректированной с учетом степени тяжести ВНПЖ. До и после курса ЗФТ оценивалась динамика антропометрических [масса тела, индекс массы тела (ИМТ)] и лабораторных показателей нутритивного статуса (общий белок, альбумин, витамины D и В12, трансферрин, железо и магний). Результаты. После завершения ЗФТ в обеих группах отмечена достоверная тенденция к увеличению показателя ИМТ пациентов. В I группе данный показатель вырос с 21,45 [95% доверительный интервал (ДИ) 19,80 - 23,92] кг/м2 до 22,15 (95% ДИ 20,31-23,86) кг/м2, а во II - с 19,22 (95% ДИ 18,33-21,99) кг/м2 до 22,0 (95% ДИ 19,97-24,08) кг/м2. При этом длительность ЗФТ (месяцев) достоверно коррелировала с динамикой массы тела пациентов (r=0,4679; 95% ДИ 0,2384-0,6479, p=0,0002). При оценке лабораторных маркеров нутритивного статуса после ЗФТ выявлена общая тенденция к повышению уровня общего белка, альбумина, витамина D, магния, трансферрина и железа в обеих группах, однако статистически достоверные различия в динамике отмечались преимущественно во II группе пациентов. Так, уровень общего белка во II группе увеличился с 69,05 (95% ДИ 65,6717-70,9000) г/л до 72,8 (95% ДИ 71,1358- 74,9000) г/л, витамина D - с 10,6 (95% ДИ 32,8397-38,9603) нг/мл до 17,1 (95% ДИ 12,0166-23,6232) нг/мл, магния - с 0,72 (95% ДИ 0,6892-0,7825) ммоль/л до 0,795 (95% ДИ 0,7692-0,8800) ммоль/л, а трансферрина - с 2,91 (95% ДИ 2,1800- 3,3656) г/л до 2,92 (95% ДИ 2,4000-3,5200) г/л. Заключение. Проведенное проспективное наблюдательное исследование продемонстрировало эффективность ЗФТ с использованием микрокапсулированных препаратов панкреатина при коррекции нутритивного статуса у пациентов с ХП.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Bideeva TV,Maev IV,Kucheryavyy YA,Andreev DN,Shah YS,Lobanova EG,Zaborovskiy AV,Levchenko AIdoi
10.26442/00403660.2020.01.000488subject
Has Abstractpub_date
2020-01-15 00:00:00pages
30-35issue
1eissn
0040-3660issn
2309-5342journal_volume
92pub_type
杂志文章abstract:AIM:To investigate the effect of recombinant alpha 2b-interferon (r alpha 2b-IFN) on functional capacity of peripheral blood (PB) T cells in rheumatoid arthritis (RA) patients and the relationship between functional characteristics of T lymphocytes and the disease activity. MATERIALS AND METHODS:PB mononuclear cells (...
journal_title:Terapevticheskii arkhiv
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doi:
更新日期:2000-01-01 00:00:00
abstract::Forty-one patients suffering from chronic systemic lupus erythematosus with Raynaud and Sjögren's syndromes and 18 patients with an acute and subacute disease course were examined. It was established that chronic SLE was marked by a high frequency of antibodies to ribonucleoprotein, an increase in the concentration of...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The authors describe the results of a study into antioxidants (superoxide dismutase and catalase) and production of the active forms of oxygen (superoxide anion radical, hydrogen peroxide, hydroxyl radical, and singlet oxygen) by blood and bone marrow leukocytes from patients with Fanconi's anemia. The generation of t...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:AIM:To study antianginal effectiveness of trimetazidine (TMS) in monotherapy and combined antianginal therapy; to design approaches to prediction of its effect. MATERIAL AND METHODS:An open cross-over randomised trial enrolled 29 anginal patients. They were given a single TMS dose (60 mg) and its effect was compared t...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2000-01-01 00:00:00
abstract::The aim of the present research was to study the efficacy of the immunomodulating agent T-activin in patients with viral myocarditis and dilated cardiomyopathy (DCMP). The data obtained indicate that under the influence of the general therapy with T-activin cellular immunity manifested positive changes and the patient...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::The paper is concerned with a comparative study of the evidence of case histories, clinical symptomatology, external respiratory function and the effect of beta-adrenergic drugs in patients with bronchial asthma to define conditions contributing to the development of a bronchospasm caused by submaximum physical exerti...
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pub_type: 杂志文章
doi:
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abstract:AIM:To evaluate the effect of the anxiolytic adaptol on blood pressure (BP) level in its concurrent use with a fixed dose angiotensin-converting enzyme (ACE) inhibitor/diuretic combination on quality of life and on the correction of psychoautonomic disorders. SUBJECTS AND METHODS:The trial included women aged 40-60 ye...
journal_title:Terapevticheskii arkhiv
pub_type: 临床试验,杂志文章
doi:
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abstract::The author describes 2 cases of erroneous prescription of rumalon to patients with rheumatoid arthritis (RA), as a result of which in one of the patients oligoarthritis arthritis while in the other one the typical seropositive slow-progressing rheumatoid arthritis transformed to RA with systemic manifestations. ...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:AIM:To study effects of pacemaker implantation on the course of coronary heart disease (CHD) with stable angina pectoris and choice of optimal regimen of pacing. MATERIAL AND METHODS:A total of 154 CHD patients with a pacemaker were examined. All the patients had angina of effort of functional class II-IV. RESULTS:Th...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::Of 55 untreated patients with erythema migrans only 20% were free of follow-up manifestations of Lyme's disease. The rest exhibited episodes of articular, periarticular or musculoskeletal pains (18%), one or more episodes of arthritis (51%) or chronic arthritis (11%). Lyme's arthritis arises due to invasion of Borreli...
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doi:
更新日期:1995-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Mitral prolapse (MP) investigations were performed in 76 pilots. MP occurs in pilots rather frequently and in 15% may be responsible for syncope conditions resultant from cardiac arrhythmia, coronaroangiospastic and hypotonic responses to stress. MP diagnosis requires comprehensive examination combining clinical and s...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::The regular character and a tendency of the time course of the absolute activity of the heart-specific blood enzymes and their coefficients in focal myocardial dystrophy, angina of effort and rest, angina of effort and unstable angina after each attack of chest pains and their recurrences which were identical to those...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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doi:
更新日期:2012-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract::Study of changes in the electrocardiogram during spontaneous attacks of angina pectoris has shown that out of 80 patients examined, 78 (98.6%) patients with angina pectoris at rest manifested ischemic-type changes in the end part of the ventricular complex of the ECG, whereas in 81% of the patients, rhythm and conduct...
journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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doi:
更新日期:1993-01-01 00:00:00
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doi:
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journal_title:Terapevticheskii arkhiv
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更新日期:1991-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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更新日期:2007-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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doi:
更新日期:1990-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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更新日期:1991-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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更新日期:1993-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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doi:
更新日期:2007-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
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