RU2194520C2 - Method for treating and preventing cardiovascular diseases - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: the suggested method deals with introducing the suspension of alive cells of attenuated streptokinase museum strain of symbiont bacteria at the dosage of 50-100 mmt twice - with prophylactic purpose, thrice and more times at the background of conventional therapy - in case of treating cardiovascular diseases. The method in question increases blood concentration of streptokinase - an activator of fibrinolysis. EFFECT: higher efficiency of therapy. 1 cl, 1 dwg, 4 ex

Description

 The invention relates to medicine and biology and can be used for the prevention and treatment of cardiovascular diseases (CVD), including coronary heart disease (CHD) and brain, pre-infarction state, as well as damage to limb arteries (atherosclerosis, thromboangiitis obliterans).

 This method may be most effective for preventing the occurrence of acute cardiovascular conditions associated with rapid depression of fibrinolysis and spontaneous intravascular thrombosis (myocardial infarction, stroke, etc.).

 A known method of treating cardiovascular diseases using basic drug therapy and autovenous ultraviolet irradiation of blood to activate fibrinolysis. (1).

 The main disadvantages of the known methods include the inability to eliminate the state of depression of fast-acting fibrinolysis and to prevent the occurrence of spontaneous intravascular thrombosis (myocardial infarction, stroke, etc.), as well as their insufficient therapeutic effectiveness.

 The invention is aimed at solving problems: increasing the efficiency of the method by reducing mortality from CVDs, which for Russia over the past 30 years has amounted to 50% of all deaths. (3).

 This is achieved by preventing the occurrence of acute cardiovascular conditions associated with spontaneous intravascular thrombosis (myocardial infarction, stroke, pre-infarction condition, etc.) caused by emergency fibrinolysis depression.

 The use of this invention can be shown in violation of the circulatory processes, including microcirculation.

 These tasks are achieved by increasing the concentration in the blood and lymph of the bacterial fibrinolytic enzyme streptokinase (introduced during the restoration of the bacterial carriage of a streptokinase active strain of symbiont bacteria), an activator of fibrinolysis of an emergency action - the plasmin system.

 The bacterial enzyme streptokinase is a necessary natural element of the system of emergency enzymatic fibrinolysis - a plasmin system that performs in the human body a lightning catalytic process of decomposition of fibrin clots falling from the blood stream, blood clots and reducing blood viscosity.

 The plasmin system constantly maintains a liquid state of blood in the bloodstream and improves its rheological properties (dilution), which prevents spontaneous intravascular thrombosis and significantly improves hemodynamics and blood supply to the entire microcapillary bed.

 The plasmin fibrinolytic system is an enzymatic system of great potential strength, providing, in the presence of the bacterial streptokinase enzyme in the blood and lymph, up to 98% fast-acting fibrinolysis. (2).

 The biological laws of the blood coagulation process and the fibrinolysis system with the inclusion of the streptokinase enzyme are presented in the fundamental work of Czech researchers Raska K. and Rotta J. (4) - (see drawing).

 The restoration of the bacteriocarrier of streptokinase-producing bacteria and normal microbiocenosis of the human body, created during evolution and lost during the widespread use of antibacterial agents, is achieved by intradermal administration of small doses of a suspension of living cells of an attenuated museum streptokinase-active strain of symbiotic bacteria that permanently produce enzyme activators: plasmin systems; lipoproteinase enzyme that breaks down blood cholesterol and a number of other necessary enzymes that regulate homeostasis.

 The proposed method is as follows. As a rule, a suspension of living cells of an attenuated streptokinase-active museum strain of symbiotic bacteria in a sterile physiological solution at a dose of 50-100 mmt is injected intracutaneously into the patient's skin, twice for prophylactic purposes and three times or more in the treatment of chronic CVD during traditional therapy with intervals between administrations.

 Contraindications: acute myocardial infarction, unstable angina pectoris.

 Examples of specific performance.

 Example 1. Patient E., 44 years old.

 Diagnosis: ischemic heart disease. Angina pectoris, II functional class. Postinfarction cardiosclerosis (03/25/99). Ventricular extrasystole. H I.

 Complained of chest pain with moderate physical exertion, weakness, increased fatigue. 03/25/99, suffered an acute transmural anteroposterior myocardial infarction with spread to the apex of the left ventricle. He received treatment with nitrosorbide 30 mg / day, capotene 12.5 mg / day, acetylsalicylic acid 250 mg / day.

Objectively: the condition is satisfactory. Heart rate - 66 per minute. HELL - 120/80 mm Hg, T 36.5 ^o C. Heart sounds are muffled. The vesicular breathing.

 The abdomen is soft, painless. The liver is not enlarged. No peripheral edema.

 ECG: cicatricial changes in the anterior-septal region of the left ventricle. Bicycle ergometry test: medium load tolerance. The threshold load power is 120 watts.

 Echocardiography: heart cavities are not dilated. Hypokinesia of the apical and anterior septal segments of the left ventricle. Myocardial contractility is slightly reduced. The ejection fraction is 52%.

 Coagulogram: prothrombin time 14 s, activated partial thromboplastin time 43 s, fibrinogen 3.8 g / l, XIIa-dependent fibrinolysis 5 min, plasma lysis induced by streptokinase, more than 10 min; ADP platelet aggregation 15 s. Conclusion: inhibition of fibrinolysis.

 Conjunctival biomicroscopy: total conjunctival index of 14 points. Functional changes in the vascular wall.

 With the patient's consent, from October 7, 1999, the patient was injected with living cells of an attenuated streptokinase-active museum strain of symbiont bacteria (in physiological saline) at a dose of 50 mmt three times, then according to the 2nd scheme - 100 mmt, 3rd - 100 mmt with intervals between administrations .

 After the restoration of microbiocenosis, there are no complaints of chest pain. Marks a decrease in weakness.

 Coagulogram: prothrombin time 14 s, activated partial thromboplastin time 46 s, fibrinogen 4.3 g / l, XIIa-dependent fibrinolysis 7 min; streptokinase-induced plasma lysis, 7 min; ADP platelet aggregation 16 s. Conclusion: inhibition of fibrinolysis.

 Conjunctival biomicroscopy: general conjunctival index of 6 points. Variant of the norm.

 Thus, as a result of the restoration of normal microbiocenosis, attacks of angina pectoris disappeared. According to the coagulogram, fibrinolysis was activated, as evidenced by a decrease in the plasma lysis time activated by streptokinase. Improvement of microcirculation processes is fixed by conjunctival biomicroscopy in dynamics.

 Example 2. Patient G., 52 years old.

 Diagnosis: Thromboangiitis obliterans (Buerger's disease). Occlusion of the popliteal artery on the left, arteries of the lower leg on the right, arteries of the hand on the right. Amputation stump of the lower leg on the left. KHAN III A.

 The patient complained of pain, a feeling of cooling in the right foot. He received treatment with acetylsalicylic acid, trental, nicotinic acid.

 Objectively: signs of inflammation in the right foot (swelling, crimson skin), an ulcer in the region of the first finger.

 Rheovasogram: blood supply to the vessels of the right foot is violated, IV tbsp. (RI - 0.25); right lower leg - reduced, I tbsp. (RI - 0.82).

 With the consent of the patient, from 13.04.99, a suspension of living cells of an attenuated streptokinase-active museum strain of symbiont bacteria (in physiological saline) was introduced. The first intradermal injection at a dose of 50 mmt, the second and subsequent ones according to the scheme. No complications were observed.

 At re-examination after 9 months. the patient noted a decrease in pain in the right foot. Signs of inflammation are less pronounced. An ulcer healed in the region of the first toe of the right foot.

 Rheovasogram: blood supply to the vessels of the right foot is violated, III tbsp. (RI - 0.34); the right lower leg - reduced, Art. I (RI - 1.02).

 According to rheovasography, the dynamics revealed an improvement in blood supply in the region of the right lower limb.

 Example 3. Patient D., 71

 Diagnosis: atherosclerosis, combined lesion, coronary heart disease. Angina pectoris, III functional class. Postinfarction cardiosclerosis (1986). Stenosis of the common carotid artery on the left, both subclavian arteries. Iliac artery stenosis on the left. Occlusion of PBA on both sides. Essential arterial hypertension III Art. XHMK III Art. KHAN II B

 Complaints of pain behind the sternum and lower extremities after 100 m walk. The treatment was carried out with nitrates, AFP inhibitors, calcium antagonists, trental, aspirin.

Objectively: heart rate - 68 rpm, blood pressure - 170/100 mm Hg, T 35.1 ^o C. Accent II tone, systolic murmur on the aorta. The vesicular breathing. The abdomen is soft, painless. Peripheral edema is absent. Ripple aatib.post. not determined.

 ECG: scars on the back wall, left ventricular hypertrophy.

 Coagulogram: prothrombin time 14.5 s, activated partial thromboplastin time 37 s, fibrinogen 6.5 g / l, XIIa-dependent fibrinolysis 7 min; streptokinase-induced plasma lysis, 158 s, ADP platelet aggregation 13 s. Conclusion: hyperfibrinogenemia, platelet hyperaggregation.

 Rheovasography of the lower extremities: violation of the blood supply of an organic nature on the legs and feet, more on the right. RI in the region of the legs: on the left - 0.45; on the right - 0.30. RI in the area of the feet: on the left - 0.30; on the right - 0.15.

 Ultrasound dopplerography of the lower extremities: stenosis of the iliac-femoral segments on both sides, more pronounced on the right. Occlusion of superficial femoral arteries. The blood flow in the rear of the foot on the right is not located.

 Since February 16, 1999, upon receipt of informational consent, the patient underwent a course of treatment by intradermal injection of a suspension of living cells of an attenuated streptokinase-active museum strain of symbiotic bacteria (in physiological saline) four times at a dose of 50-100 mmt with intervals between administrations. There were no complications.

 After treatment, the patient has reduced angina attacks to 1-2 times a day. The distance traveled without pain in the legs increased to 200 m.

 Coagulogram: prothrombin time 14 s, activated partial thromboplastin time 41 s, fibrinogen 4.8 g / l, XIIa-dependent fibrinolysis 6 min; ADP platelet aggregation 13 s. Conclusion: platelet hypereaggregation.

 Rheovasography of the lower extremities: blood supply to the vessels of the legs and feet is reduced. RI in the region of the legs: on the left - 1.0; on the right - 0.85. RI in the area of the feet: on the left - 0.82; on the right - 0.45.

 Ultrasound dopplerography of the lower extremities: signs of collateral blood supply in the region of the right foot appeared.

 Thus, after the restoration of normal microbiocenosis, the patient has reduced bouts of angina pectoris, and symptoms of intermittent claudication have decreased. Positive changes in the state of hemostasis resulted in a decrease in fibrinogen level and activation of fibrinolysis. According to rheovasography and ultrasound dopplerography of the lower extremities, an improvement in blood supply to the legs and feet with an increase in collateral circulation was noted.

 Example 4. Patient M., 46 years old.

 Diagnosis: thromboangiitis obliterans. Consequences of acute cerebrovascular accident (1991, 1993, 1995, 1996). Dyscirculatory encephalopathy. KNMK III Art. KHAN II B Chronic bronchitis, remission phase.

 Complained of weakness, dizziness, a feeling of "numbness" of the rear of the right foot. For a long time received treatment with antiplatelet agents, nicotinic acid. In stationary conditions, courses of anticoagulant therapy were repeatedly conducted.

 Objectively: heart rate - 72 per min. HELL - 130/80 mm Hg Heart sounds are muffled. The breath is hard. The abdomen is soft, painless. No peripheral edema.

 Rheoencephalography: pulse blood vessels in the hemispherical region asymmetric (d> s), reduced; posterior cranial region - symmetrical, reduced. RI of the hemispheric region: on the right - 0.55; to the left - 0.40. RI of the posterior cranial region: on the right - 0.45; to the left - 0.50.

 With the consent of the patient, from April 20, 1999, a suspension of living cells of an attenuated streptokinase-active museum strain of symbiont bacteria (in physiological saline) was injected intradermally according to a certain scheme at a dose of 80-100 mmt three times with intervals between administrations.

 Subsequently, intradermal injections were repeated after 3 months once. No complications were observed.

 As a result of the treatment, the general well-being of the patient improved, dizziness decreased, and the feet became “warmer”. No follow-up stroke occurred over 1.5 years.

 According to the rheoencephalogram in the dynamics, an improvement in the blood supply to the brain was noted. RI of the hemispheric region: on the right - 0.65; to the left - 0.65. RI of the posterior cranial region: on the right - 0.70; to the left - 0.70.

 Preventive effect of intradermal injections.

For patients aged 45-50-60-75 years (more than 50 people) who received intradermal injections at a dose of 50-100 mmt twice for prophylactic purposes, observations were carried out for 10 years. Deviations in the state of health and functions of the cardiovascular system were not noted. Key indicators: body temperature in the range 36.3-36.6 ^o C, pulse - 66-72 beats / min, blood pressure 120-140 / 80-90 mm RT. Art., blood formula and rheology - normal.

 The use of drugs is only episodic.

 The use of the proposed method is intended to have a significant impact on the prevention of acute thromboembolic conditions caused by spontaneous intravascular thrombosis caused by rapid fibrinolysis depression (myocardial infarction, stroke, etc.), and to increase the effectiveness of the treatment of CVD associated with impaired vascular system functions and deep hemodynamic changes.

LITERATURE
1. Ryamzina I.N. Abstract of diss. Candidate of Medical Sciences, Perm, 1994

 2. Andreyenko G. V. Fibrinolysis (biochemistry, physiology, pathology of processes). - M.: Publishing House of Moscow State University, 1979.

 3. Oganov R.G., Maslennikova G.Ya. Cardiology. - 2000. - 6. - T. 40. - S. 4.

 4. Raska R., Rotta J. Streptokokove. - Praga, St. zdrav. nakl ad., 1966.

Claims (1)

 A method for the treatment and prevention of cardiovascular diseases, characterized in that a patient is injected intracutaneously with a suspension of living cells of an attenuated streptokinase-active museum strain of symbiotic bacteria at a dose of 50-100 mmt, twice for prophylactic purposes, three times or more against the background of traditional therapy - in the treatment of cardiovascular vascular disease.