RU2338517C1 - Method of trombocytopathy treatment at metabolic syndrome - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention concerns treatments of thrombocytopathy at a metabolic syndrome (MS). For this purpose within 24 weeks carry out the complex treatment including individually picked up hypohigh-calorie diet, and also administration of atenolol in a dose of 100 mg in the morning and duovit on 1 red and 1 dark blue tablet a day.

EFFECT: expansion of an arsenal of ways of effective correction platelet hemostasis at sick of a metabolic syndrome; reduction thrombotic complications at the expense of an optimum combination of not medicamental therapy and specific medicinal preparations.

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Description

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

At the filing date, there is a known method for normalizing platelet hemostasis by prescribing an individually selected hypocaloric diet and a beta blocker of nebivolol 1 time per day, which provides effective correction of platelet hemostasis disorders as a result of a 6-month course of treatment (RU 2268041, C1 01.20.2006), developed previously sponsored by applicants. However, nebivolol used in this method can be used by far not every patient with metabolic syndrome due to both individual intolerance of the drug and its economic inaccessibility for some patients. In this regard, the goal was to develop a more affordable method for the correction of thrombocytopathy in the metabolic syndrome using a cheaper and widely used β-blocker as a hypotensive agent.

For the metabolic syndrome, multivitamin preparations can be used (A. Makatsaria et al. Metabolic syndrome and low molecular weight heparins. "Consilium medicum. 2006. V.8, No. 6. www.consiliummedicum.com/vedia/consilium/06_35.shtml.39KБ )

However, never before has a treatment complex consisting of an individually selected hypocaloric diet, atenolol and duovit 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, thrombin, thrombin, thrombin, thrombin , adrenaline and combinations of inducers - ADP + adrenaline, ADP + collagen, adrenaline + collagen, as well as optimizing the intravascular activity of platelets, uro nya lipid peroxidation and antioxidant protection of blood platelets) for 24 weeks.

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, atenolol preparations at a dose of 100 mg once a day in the morning and duovit 1 red and 1 blue tablet per day.

The method allows you to adjust the primary hemostasis in patients with MS for six months, translating it to a level close to that for healthy people. Subject to the subsequent recommendations of the proposed method, it is possible to maintain primary hemostasis in an optimal mode of operation, 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 individually for each patient with MS is calculated in kcal 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 coefficient obtained remains unchanged with minimal physical activity, multiplied by 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. With the regular skipping of one of the main meals, the frequency of obesity increases significantly, a positive correlation between obesity and skipping breakfast is also revealed. 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 atenolol 1 time in the morning at 100 mg and duovit 1 red and 1 blue tablet per day.

Example. Patient M., 50 years old, with a body weight of 92.0 kg, a body mass index of 30.2 kg / m ² , suffering from metabolic syndrome for 10 years, examination revealed thrombocytopathy with an increase in adhesive - 47%, aggregation activity ( with ADP - 25 s, with collagen - 23 s, with thrombin - 37 s, with ristomycin - 28 s, with H ₂ O ₂ - 30 s, with adrenaline 71 s, with ADP + adrenaline 23 s, with ADP + collagen 22 s, with adrenaline + collagen - 18 s) and intravascular platelet activity (discocytes - 67%, disco-echinocytes - 19%, spherocytes - 12.1%, sphero-echinocytes - 1.9%, biopolar forms - 0%, total active forms - 33%, the number of platelets in aggregates - 15.2%, the number of small aggregates - 20 per 100 free platelets, the number of medium and large aggregates - 8 per 100 free platelets) against the background of impaired glucose tolerance and type II hyperlipidemia (total lipids - 8.9 g / l) with mild hypercholesterolemia (total cholesterol - 5.9 mmol / l). Platelet atsilgidroperekisey 3,7D was _233/10 ⁹ platelets, malondialdehyde (MDA) platelet - 1.62 nmol / 10 ⁹ platelets, platelet catalase - 3500ME / 10 ⁹ platelets, platelet superoxide dismutase - 900ME / 10 ⁹ platelets. The patient was prescribed an individually selected hypocaloric diet (2081.0 kcal.), Atenolol 100 mg once a day in the morning and duovit 1 red and 1 blue tablet per day. The patient was examined 4, 12 and 24 weeks after the start of treatment. Simultaneously with the examination, a biochemical and hematological blood test was performed.

By the 24th week of treatment, the patient returned to normal body weight (79.0 kg) and body mass index (26.0 kg / m ² ), complete normalization of the blood lipid spectrum was achieved (total lipids - 5.9 g / l, total cholesterol - 5.1 mmol / l), glucose tolerance test, blood plate adhesive function - 37%, platelet aggregation with ADP - 43 s, collagen - 36 s, thrombin - 52 s, ristomycin - 40 s, hydrogen peroxide - 49 s, adrenaline - 100 s and combinations of inducers - ADP + adrenaline - 33 s, ADP + collagen - 25 s, adrenaline + collagen - 23 s, as well as optimization of intravascular activity and platelets (discocytes - 87%, disco-echinocytes - 8.8%, spherocytes - 2.0%, sphero-echinocytes - 1.6%, biopolar forms - 0.6%, the sum of active forms - 15%, platelet count in aggregates - 6.0%, the number of small aggregates - 5 per 100 free platelets, the number of medium and large aggregates - 0.4 per 100 free lying platelets), the level of lipid peroxidation (the level of platelet acyl hydroperoxides was 2.0 D ₂₃₃ / 10 ⁹ platelets, platelet MDA 0.71 nmol / 10 ⁹ platelets) and antioxidant protection of blood platelets (platelet catalase - 8600 IU / 10 ⁹ platelets Comrade, platelet superoxide dismutase - 1420ME / 10 ⁹ platelets.

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

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 of treating thrombocytopathy with a metabolic syndrome, characterized in using an individually selected hypocaloric diet calculated in kcal according to the formula for women: 18-30 years old (0.0621 · body weight, kg + 2.0357) · 240; 31-60 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; 31-60 years old (0.0484 · body weight, kg + 3.6534) · 240; over 60 years old (0.0491 · body weight, kg + 2.4587) · 240, atenolol 100 mg in the morning and duovita 1 red and 1 blue tablet per day for 24 weeks.