RU2272633C2 - Agent for enhancing serum antioxidant activity in burn patients - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to agents enhancing serum antioxidant activity and can be used in complex treatment of burn patients. Method involves using 1% solution of apple pectin or 1% solution of beet pectin, or preparation "Pekto" as a preparation enhancing serum antioxidant activity in burn patients. Oral using these agents promotes to decreasing bacterial seeding of wounds, more early formation of granulations being without inducing allergic responses.

EFFECT: valuable medicinal properties of agent.

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Description

The invention relates to clinical medicine, namely to agents that increase the antioxidant activity of blood serum, and can be used in the complex treatment of burn patients.

The decrease in antioxidant activity (AOA), manifested by increased lipid peroxidation (LPO), plays an important role in the pathogenesis of burn disease and leads to a change in the lipid composition of membranes, a violation of their functional properties and a change in the activity of membrane-bound enzymes [Agadzhanov MI, Badzhinyan S. A., Mkhitaryan V.G. - Bull. expert. biol., 1979. - N 5. - S. 422-425; Latha B., Babu M. "Burns". - 2001. - N 27. - P.309-317]. With a burn disease in the membranes of red blood cells and serum, AOA decreases significantly, which is indirect confirmation of a decrease in the level of endogenous antioxidants in the body [Babskaya Yu.E., Lavrov VA, Olyunina N.A. - "Surgery" - 1985. - N11. - C.95-97]. The decrease in AOA and the accumulation of aggressive lipid peroxidation products in the membranes indicate a decrease in the antioxidant protection of cells. The use of antioxidants normalizes the function of membranes, the activity of enzymes, accelerates the healing of burn wounds [Taran Yu.P., Shishkina LN, Evseenko LS, Kukushkina GV "Patol. Fiziol. And experimental ter." - 1995. - N 1. - P.40-43; Smirnov S.V., Golikov P.P., Matveev S.B., Davydov B.V., Loginov L.P., Shakhlamov M.V., Promanenkov V.K. "Vestn. Intensive care". - 2002. - N 1. - P.23-25; V. G. Makarov, M. N. Makarova, A. I. Seleznev "Nutrition Issues". - 2005. - Volume 74. - No. 1. - S.10-13; Zinoviev E.V., Movchan K.N., Chichkov O.V., Levkov AL. VIII All-Russian Scientific Pract. Conf. from the international participation "Problems of treatment of severe thermal injury." - 2004. - Nizhny Novgorod. - S. 73].

Currently, a large number of drugs with antioxidant effects are known, including flavonoids, vitamins, heteroaromatic natural and synthetic antioxidants.

The objective of the invention is to expand the arsenal of tools used in the treatment of patients with burn injury to increase AOA of blood serum.

The problem is solved in that as a means of possessing AOA in burn patients, use a 1% solution of apple or 1% beet pectin or the drug "Pecto", which is a mixture of apple and beet pectin with the addition of citric acid and fructose to improve taste .

The proposed tools are cheaper compared to known and, in addition, have a bactericidal effect against many pathogenic and conditionally pathogenic microorganisms, which improves the treatment of burn patients. Oral administration of 1% solution of apple, 1% beet pectin and the drug "Pecto" in the treatment and prevention of purulent-septic complications in burn patients is known as agents with antibacterial properties. The inclusion of pectins in the complex therapy has a bactericidal effect, affecting many pathogenic and conditionally pathogenic microorganisms, which reduces the number of infectious complications to 14.3% [Lazareva EB, Smirnov SV, Khvatov VB, Spiridonova T .G., Bitkova E.E., Shramko L.U., Menshikov D.D. / "Oral use of pectins for the prevention and treatment of purulent-septic complications in burn patients." "Antibiotics and a chemotherapy." 2002. - T.47. - N 4. - S.16-19].

In the patent and scientific and technical literature, information about the use of 1% solution of apple or 1% beet pectin or the drug "Pecto" as a means of increasing AOA of blood serum in burn patients was not found.

The authors conducted studies, as a result of which it was found that 1% solution of apple, 1% beet pectin and the drug "Pecto" exhibit antioxidant properties. 2 groups of patients with burns were taken - control and main, identical in severity of condition and area of the burn surface.

Patients in the control group underwent traditional infusion-transfusion, antibacterial and symptomatic therapy.

In the treatment of patients of the main group, in addition to traditional therapy, included 1% solution of apple or 1% beet pectin or the drug "Pecto".

Serum AOA studies and wound cultures were performed in patients of both groups at the same time. To evaluate the serum AOA, the chemiluminescent system Hb H ₂ O ₂ -luminol was used.

After treatment with pectins or Pecto, AOA increased by 2-2.5 times compared with the initial level, and in the control group at the same time AOA remained virtually unchanged.

Thus, the studies showed that the proposed funds have antioxidant properties, and their use is advisable in the complex treatment of burn patients.

The proposed funds - 1% apple or 1% beet pectin is taken orally 100 ml 3 times a day 30 minutes before meals for at least 7 days. The drug "Pecto" is also taken 3 times a day 30 minutes before meals for 7 days, while the contents of the bag are diluted in 50 ml of warm water.

The effectiveness of the proposed funds is confirmed by clinical examples.

1. Patient A, 17 years old, N and a / b 10617.

Received June 24, 02. Diagnosis: burn with boiling water 40% of the body surface (IIIB - 10%).

Upon receipt, the condition is serious. The patient was in the burn intensive care unit. Pseudomonas aeruginosa in the amount of <3 lg CFU / ml was found in the wound detachment from 06.25.02. AOA - 0.92 ASU Complex treatment was carried out, including infusion-transfusion therapy (physiological saline 0.9%, 5% glucose solution, plasma, albumin), rheological drugs (reopoliglyukin), antibiotics (ampiox) and local treatment of burn wounds (furacilin ointment 2%, chlorhexidine solution )

From 2 days after taking the tests, the patient received 1% beet pectin 100 ml 3 times a day 30 minutes before meals for 7 days.

Against the background of ongoing therapy, necrectomy was performed. Staphylococcus aureus in the amount of <3 lg CFU / ml and Escherichia coli in the titer of 5 lg CFU / ml were found in the wound culture. AOA increased to 2.68 ask.ed. In a moderate state, he was transferred to the burn department of the hospital.

2. Patient A. 25 years old, N and / b 10800.

Diagnosis: a flame burn of I-II-IIIAB degree 20% of the body surface (IIIB - 6%) from 06/17/02.

The condition is serious. Staphylococcus aureus and enterococci in the amount of <3 lg CFU / ml were found in the wound site before pectin. AOA - 0.76 asc. Complex treatment was carried out, including infusion-transfusion therapy (physiological saline 0.9%, 5% glucose solution, plasma), rheological drugs (reopoliglyukin), antibiotics (ampiox) and local treatment of burn wounds (furacilin ointment 2%, chlorhexidine solution).

In addition to the therapy, the patient received orally 1% apple pectin from 4 days after the injury (from 21.06.02) for 7 days.

In a moderate state, on the 4th day after a burn injury, he was transferred to the burn department. Upon re-examination performed in the burn department after the end of pectin administration on 06/28/02, the AOA increased to 2.77 asc. Crops from the wounds were sterile.

3. Patient R. 18 years old, N and / b 10682.

Diagnosis: flame burn 19% of the body surface (IIIB - 10%) from 15 / VI-02.

Upon admission, the patient is in serious condition. AOA on the 4th day after the injury - 1.8 asc. Pseudomonas aeruginosa in the amount of 5 lg CFU / ml was detected in the wound discharge. Complex treatment was carried out, including infusion-transfusion therapy (physiological saline 0.9%, 5% glucose solution, plasma), rheological drugs (reopoliglyukin, trental), antibiotics (ampiox) and local treatment of burn wounds (Levomekol ointment, chlorhexidine solution). The drug "Pecto" began to receive from 19 / VI. The course of treatment was 7 days. The contents of the bag were diluted in 50 ml of water. I took 1 sachet 3 times 30 minutes before a meal.

After treatment, a moderate condition. Bacteriological examination of the wound discharge revealed single colonies of Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli. AOA increased to 2.29 ask.ed. Against the background of the course of treatment with the drug "Pecto", a necrectomy operation was performed.

Thus, all patients had a smooth course of burn disease without infectious complications. After autodermoplasty, 100% engraftment of autologous flaps and healing of donor wounds without suppuration were observed.

In the control group there were three patients who did not use pectins in the complex of therapeutic measures. Serum AOA studies and wound cultures were performed at the same time as in patients treated with pectin. We give clinical examples.

4. Patient S. 40 years, N and a / b 9427.

Diagnosis: flame burn of 27% of the body surface (IIIA - 10%) from 05.23.03.

The examination was carried out on the 4th day after receiving a burn. Staphylococcus aureus in the amount of 8 lg CFU / ml was isolated from the wound discharge. AOA of serum - 1.13 asc. The condition is serious. The patient was in the burn intensive care unit.

Complex therapy was carried out, including transfusion of reopoliglyukin, plasma, glucose-salt solutions. Antibacterial therapy included intramuscular administration of ampiox 1.0 g 4 times a day. Wet-drying dressings with iodopyrone were used on the wounds.

After 7 days, the condition remained severe. The patient remained in the intensive care unit. There was a partial epithelization of the surface of burn wounds of the II degree. Grades IIIA wounds were cleansed of superficial necrosis. In addition to Staphylococcus aureus in the amount of 3 lg CFU / ml, streptococci (6 lg CFU / ml) and Klebsiella (4 lg CFU / ml) were found in the crop. AOA of serum even decreased slightly and amounted to 0.97 asc.

5. Patient F., 55 years old, N and a / b 9822.

Diagnosis: flame burn 28% p.t. (IIIB - 12%) from 05/28/03

The condition at admission is serious. Conducted antishock therapy for 2 days.

06/02/03, wounds under thin dry scabs of dark color with minimal wound detachable along the edges of the scab. Material was taken for bacteriological examination in which epidermal staphylococcus was detected in an amount of <3 lg CFU / ml. AOA 1.2 ased Intensive therapy was carried out, including infusion-transfusion treatment, transfusion of blood, plasma, heparin, antispasmodics, the introduction of antibiotics: ceftazidime 1.0 × 3 times a day intravenously.

06/09/03, During the observation period in the patient's condition, significant positive dynamics did not occur. The patient remained in the intensive care unit. Staphylococcus aureus and Escherichia coli in the amount of 5 lg CFU / ml were present in the wound discharge. AOA of blood serum 1.33 asc.

6. Patient D. 20 years, N and / b 9251.

Diagnosis: a flame burn of 20% bp (IIIB - 6%) dated 05/21/03

Upon receipt, a moderate condition. Conducted antishock therapy. The condition was stable. A day later, transferred from the intensive care unit to the burn. He received prophylactic antibiotic therapy with 1.0 g of ampiox. 4 times intramuscularly.

Coagulase-negative staphylococcus in the amount of 4 lg CFU / ml and enterococci 8 lg CFU / ml were found in the cultures from wounds. Serum AOA 0.98 ASU

On May 28, 2003, a necrectomy was performed on an area of 6%.

06/29/03, during ligation after surgery, material was taken for bacteriological examination, from which Staphylococcus aureus in the amount of 6 lg CFU / ml, Pseudomonas aeruginosa (3 lg CFU / ml) and Proteus in the titer of 5 lg CFU / ml were isolated. Serum AOA 0.9 asc.

As a result of examination of patients who did not receive pectin, it was found that the increase in antioxidant activity of blood serum over the same period as in patients whose pectin was included in the complex of therapeutic measures was insignificant. Reparative processes in wounds proceeded more slowly and did not observe significant positive dynamics in the state of microflora, and in some cases there was even an increase in the species and quantitative composition of microorganisms in wounds. Patients remained in the burn intensive care unit longer.

Thus, the use of a 1% solution of apple or 1% beet pectin or the drug "Pecto" orally promotes an increase in AOA of blood serum and a decrease in microbial contamination of wounds. Pectin intake should be started as early as possible and taken during toxemia and septicotoxemia. Wounds with superficial burns heal faster of thin necrosis, and earlier epithelization is observed, and with deep burns, earlier formation of granulations suitable for autodermoplasty is noted. In addition, pectins are not toxic and do not give allergic reactions.

Claims (1)

The use of a 1% solution of apple or 1% solution of beet pectin or the drug "Pecto" in burn patients as a drug that increases the antioxidant activity of blood serum.