The trophological status of patients with osteoarthrosis and excretory insufficiency of pancreas
Keywords:primary osteoarthrtrosis, excretory insufficiency of pancreas, trophological status, dysbiosis of colon
Background. Studies found a high incidence of the gastrointestinal tract (GI) diseases in patients with OA, especially those that are accompanied by a violation of the excretory insufficiency of pancreas (EIP), which also contributes to the activation of proteolysis. The EIP in patients with OA is formed at the comorbid pathologies: chronic pancreatitis (CP) with EIP and incretory insufficiency in the form of diabetes mellitus (DM), functional biliary disorders, diseases of the liver and bile-excreting system, diseases of the gastroduodenal zones, enterocolitis and colon dysbiosis (CD); as a result of long-term treatment of OA using the non-steroidal anti-inflammatory drugs, steroids, chondroprotectors and chondrostimulators, etc. The purpose of the work was to study the state of the proteolysis system and immune status (IS), the presence and depth of the CD in patients with primary OA against a violation of their EIP. Materials and methods. There were 64 outpatients with primary OA (group 1) and 74 patients with primary OA in combination with diseases associated with EIP (group 2). The control group consisted of 30 healthy people. Results. It was proved that there is a deeper excitation of the excretory function of the pancreas (severe) in patient with OA and comorbid pathologies of the gastrointestinal tract with EIP, as well as the presence of EIP in patients with mild OA without the clinically available EIP. In patients with primary OA that went through the isolation or in combination with the diseases accompanied by the EIP, a statistically significant activation of the total proteolysis by the level of PRA was established. Also, the analysis showed the presence of an increase in specific proteolysis, or kininogenesis, by the level of proteolytic enzyme KK. In the examination of patients, dysbiotic changes of varying degrees were detected in both groups of the study: group 1 in 25 (39.06%) patients, the CD was 1 gr., in 18 (28.13%) – CD was 2 gr. In group 2 CD 1 gr. was in 35 (47.30%) patients, in 24 (32.43%) - CD 2 gr. In group 2, dysbiotic changes were significantly deeper than in group 1. This indicates a statistically weaker course in patients with the comorbidity conditions of the primary OA and gastrointestinal tract diseases and with EIP. The obtained results indicate the presence of secondary immune deficiency in the patients under study (T-lymphocytopenia was detected in І-ІІ degrees with a decrease in all subpopulations of T-lymphocytes) and non-specific activation of the humoral part of the immune system and the inflammatory process (depletion of the total hemolytic activity of the complement, statistically significant increase of B –lymphocytes level with growth of level of all classes Ig (more Ig A and Ig M), circulating immune complexes). However, statistically more significant changes were observed in group 2, indicating the progression of the detected changes in comorbidity conditions.
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