RU2272628C1 - Method for rapid optimization of platelet function at metabolic syndrome - Google Patents

Abstract

FIELD: medicine, cardiology, endocrinology.

SUBSTANCE: method involves administration of amlodipine in the dose 5 mg, once in the same time and metformin in the dose 500 mg, 2 times per 24 h in patients at the background of individually selected hypocaloric diet. Treatment is carried out for 8 weeks, not less. Method provides optimization of intravascular activity of platelets due to correction of primary homeostasis and the level of their antioxidant protection. Invention can be used for rapid optimization of functions of platelets at metabolic syndrome.

EFFECT: improved and enhanced method for optimization.

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Description

The invention relates to medicine, namely to hematology, cardiology and endocrinology.

Analogues of the proposed method for the rapid correction of platelet hemostasis in patients with metabolic syndrome (MS) does not exist.

There are recommendations in the literature on the appointment of a hypocaloric diet for metabolic correction in the metabolic syndrome (Almazov V.A., Blagosklonnaya Y.V., Shlyakhto E.V., Krasilnikova E.I. Metabolic cardiovascular syndrome. St. Petersburg: Izd. St. Petersburg State Medical University. 1999. - 208 pp.) And reducing the degree of abdominal obesity, which is its component with the help of recommendations focused on the use of a low-calorie diet (Savelyeva L. Modern approaches to the treatment of obesity. // Doctor, 2000, No. 12, - p. 12-14; Kadyrova R.Kh., Salkhanov B.A. Nutrition for obesity. Alma-A and "Kazakhstan", 1990).

Metformin is widely used in patients with MS to correct their insulin resistance and dyslipidemia (Demidova I., Ignatova N., Reidis I. Metformin (siofor): mechanism of action and clinical use. // Clinical endocrinology. 1998. - No. 1. - S.3-27).

To correct blood pressure in the metabolic syndrome, calcium antagonists are used, one of which is amlodipine.

However, never before has a treatment complex consisting of an individually selected hypocaloric diet and amlodipine and metformin preparations been used in patients with arterial hypertension with metabolic syndrome to normalize platelet hemostasis (adhesive function of blood platelets, platelet aggregation with ADP, collagen, t, thrombin, , hydrogen peroxide, adrenaline and combinations of inducers - ADP + adrenaline, ADP + collagen, adrenaline + collagen, as well as optimizing the intravascular activity of platelets, match lipids and antioxidant protection of blood platelets peroxidation).

The aim of the invention is to increase the efficiency of correction of platelet hemostasis in patients with metabolic syndrome.

The essence of the proposed method lies in the fact that for the correction of platelet hemostasis, patients with metabolic syndrome are prescribed for a long time an individually selected hypocaloric diet, the drug amlodipine at a dose of 5 mg once a day and the drug metformin 500 mg 2 times a day.

The method allows to correct primary hemostasis in patients with MS for two months, translating it to a level close to that for healthy people. If you follow the recommendations of the proposed method, it is possible to maintain primary hemostasis in an optimal mode of functioning, which will significantly reduce the risk of thrombotic complications, reduce the number of cases of temporary disability, speed up and improve the quality of inpatient care, reduce disability, and also extend the life and reduce mortality of patients with MS from a heart attack and stroke.

The inventive method is as follows.

To create a negative energy balance in the body of patients, they are recommended an individually selected hypocaloric diet.

The caloric content of the daily diet is calculated in calla individually for each patient with MS according to the formula:

for women 18-30 years old (0.0621 × body weight, kg + 2.0357) × 240,

31 years - 60 years (0.0342 × body weight, kg + 3.5377) × 240,

over 60 years old (0.0377 × body weight, kg + 2.7545) × 240,

for men 18-30 years old (0.0630 × body weight, kg + 2.8957) × 240,

31 years - 60 years (0.0484 × body weight, kg + 3.6534) × 240,

over 60 years old (0.0491 × body weight, kg + 2.4587) × 240.

The obtained value remains unchanged with minimal physical activity, multiplied by a coefficient of 1.3 for moderate and 1.5 - for high physical activity (as a rule, in patients with MS the level of physical activity is low).

3 main meals and 2 intermediate meals are recommended. The following daily calorie distribution is recommended: breakfast - 25%, 2nd breakfast - 10%, lunch - 35%, afternoon tea - 10%, dinner - 20%.

To compile the patient’s menu, special tables are used with indications of the chemical composition and calorie content of the products, given that the main sources of energy are proteins (1 g contains 4 kcal), fats (9 kcal), carbohydrates (4 kcal) and alcohol (7 kcal).

The second component of the proposed method is the appointment of amlodipine 5 mg 1 time at the same time. The third component is metformin 500 mg 2 times a day.

Example 1. Patient K., 57 years old, with a body weight of 92.9 kg, a body mass index of 33.6 kg / m ² (protocol No. 003), suffering from metabolic syndrome for 12 years, revealed a thrombocytopathy with an increase platelet adhesion, aggregation and intravascular activity against the background of impaired glucose tolerance and type II hyperlipidemia with mild hypercholesterolemia. The patient was prescribed an individually selected hypocaloric diet (1611.5 kcal), metformin 500 mg 2 times a day and amlodipine 5 mg 1 time per day. The patient was examined 4 and 8 weeks after the start of treatment. Simultaneously with the examination, a biochemical and hematological blood test was performed.

By the end of the 8th week of treatment, the patient's body weight (86.4 kg) and body mass index (31.4 kg / m ² ) decreased, optimization of the blood lipid spectrum and normalization of the glucose tolerance test, weakening of lipid peroxidation of blood plasma and enhancing the antioxidant potential of the liquid part of the blood, normalizing the adhesive function of blood plates, platelet aggregation with ADP, collagen, thrombin, ristomycin, hydrogen peroxide, adrenaline and inducer combinations - ADP + adrenaline, ADP + collagen, adrenaline and collagen, adrenaline + nor collagen malization of intravascular activity of platelets, the level of lipid peroxidation in them and antioxidant protection of blood platelets.

The patient was asked to follow the recommendations given to her in the future.

Example 2

In patient L., 44 years old, with a body weight of 90.2 kg, a body mass index of 31.8 kg / m ² (protocol No. 004), suffering from metabolic syndrome for 5 years, thrombocytopathy with an increase in adhesive and aggregation was revealed during the examination and intravascular platelet activity against the background of impaired glucose tolerance and type II hyperlipidemia with mild hypercholesterolemia. The patient was prescribed an individually selected hypocaloric diet (2066.2 kcal), metformin 500 mg 2 times a day and amlodipine 5 mg 1 time per day. The patient was examined 4 and 8 weeks after the start of treatment. Simultaneously with the examination, a biochemical and hematological blood test was performed.

By the end of the 8th week of treatment, the patient's body weight decreased (83.6 kg) and body mass index (29.5 kg / m ² ), optimization of the blood lipid spectrum, glucose tolerance test, plasma lipid peroxidation and antioxidant potential were achieved. the liquid part of the blood, normalization of the adhesive function of blood plates, platelet aggregation with ADP, collagen, thrombin, ristomycin, hydrogen peroxide, adrenaline and combinations of inductors - ADP + adrenaline, ADP + collagen, adrenaline + collagen, and also intravascular activity s, the level of lipid peroxidation and antioxidant protection of blood platelets.

The patient was recommended to follow the instructions thereafter.

Using the proposed method for the correction of platelet disorders in hematology, cardiology and endocrinology will help to avoid many vascular complications in patients with metabolic syndrome, reduce the number of cases of temporary disability, reduce the duration of hospitalization, reduce disability and mortality.

Claims (1)

A method for the quick correction of platelet hemostasis in patients with metabolic syndrome, including the use of an individually selected hypocaloric diet and amlodipine 5 mg 1 time at the same time of the day and metformin 500 mg 2 times a day.