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The particularities of clinical course and complex treatment of duodenal ulcer in elderly patients


Author: Natalia Antonova
Degree:doctor of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2007
Scientific adviser: Ion Butorov
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 31 January, 2007
Approved by NCAA on the 19 April, 2007

Abstract

Adobe PDF document0.25 Mb / in romanian

Keywords

duodenal ulcer, elderly patients, ozonized physiologic saline, cytoprotector BioR, peroxidation of lipids, antioxidant protection, immune status, lipid metabolism, microcirculation

Summary

During complex investigation done in 75 elderly individuals suffering of duodenal ulcer, it was revealed that 64% of cases the disease run in algesic variant and 20% of cases - in dyspeptic variant. It was detected that in the majority of examined patients the sizes of ulcerous defect exceeded 1,0 cm, the illness was accompanied by signs of chronic immune process, which were manifested by suppression of T-helpers and T-suppressors and by decrease of production of immunoglobulines M, G and B lymphocytes. Along with above-mentioned abnormalities it was detected the dislipoproteinemia due to growth of concentration of cholesterol, triglycerides, LDL cholesterol and reduction of the concentration of HDL cholesterol; besides it was detected the high intensity of lipid peroxidation and decrease of activity of antioxidant protection. In 73,3% of cases in elderly aged patients with duodenal ulcer was revealed severe, in 20% – highly expresses and in 6,7% - modest abnormalities of microcirculation.

When standard triple scheme of treatment was used in elderly patients, the stopping of pain and dyspeptic syndromes, and scarring of ulcerous defect happened two times slower than under the same conditions in middle-aged patients. After adding the cytoprotector BioR or ozonized physiologic saline normal to the standard treatment scheme it helped for earlier disappearing of pain and dyspeptic syndromes, shrinking of the terms of scarring of ulcerous defect. The combination of cytoprotector BioR with triple components scheme of counter-ulcerous treatment helped to decrease the content of cholesterol, triglycerides, LDL cholesterol and reduce of the concentration of HDL cholesterol, and in increasing the level of T-helpers and T-suppressors, and production of immunoglobulines of M, G and В lymphocytes. Base treatment in combination with ozone-therapy provides the strenghtening of antioxidant protection, the suppression of intensity of lipid peroxidation and favored to state of microcirculation, which leads to fastest achievement of clinical effect and scarring of ulcerous defect in shortest period of time