THE EFFECT OF ENDOTHOXICOSIS ON THE FORMATION OF THE PANCREAS EXOCRINE INSUFFICIENCY IN PATIENTS WITH PRIMARY OSTEOARTHRITIS
Keywords:osteoarthritis, exocrine pancreatic insufficiency, endothoxicosis
Background. The development of endogenous intoxication (EI) leads to acute or chronic homeostasis disorders and leads to dysfunction of all organs and systems. Under the influence of endogenous toxins, microcirculatory disorders, hypotension, hypovolemia develop, which lead to hypoxia, dystrophy and hypofunction of all organs, including the pancreas. The purpose was to study EI syndrome in patients with pancreas exocrine insufficiency (PEI) with primary osteoarthritis and to analyze the possible correlation of indicators of this syndrome with other parameters. Materials and methods. There were 115 outpatients with PEI disorders and primary osteoarthritis examined. Diagnosis of primary osteoarthritis was determined based on diagnostic criteria, X-Ray stage - according J.H. Kellgren and J.S. Lawrence. Degree of exocrine pancreatic insufficiency was verified based on result of fecal elastase-1, which was done by Elisa test. The structural status of the pancreas was evaluated by the Cambridge Classification, assessing the severity of the process. To evaluate the process of endogenous intoxication in clinical practice used the method of determining the level of molecules of average mass (MAM) in the blood plasma in the modification of N. I. Habrielyana et al. The level of EI was judged by the level of sorption capacity of erythrocytes, which was determined according to the method A.A. Togaibaeva. Results. Analysis of the obtained indices of fecal elastase-1 levels in the study groups showed the presence of CHF in the study group - (58,65±4,73) mcg - compared with the control group (213±6,29 mcg) (p<0,05). The analysis showed statistically significant deepening of indicators of EI syndrome in patients with PEI with primary osteoarthritis of older age, indicating the progression of pathologies in these patients by age. It was found that between most pairs in the correlation analysis there are statistically significant moderately strong correlation relationships, and between the level of a-elastase and MAM, с.u, at 254 nm significant significant correlation relationship (p<0,05). Conclusions. The presence of pronounced PEI in the group of patients with primary osteoarthritis undergoing fecal elastase-1 was found to be statistically significantly lower and comparable to the control group (p<0,05). Patients with PEI and primary osteoarthritis have statistically significant increase in endotoxicosis control by MAM levels, which were increased by 43,19% and 54,26%, respectively, and LEI, which was increased by 95,93% (p<0,05). An analysis of changes in EI syndrome in patients with PEI and primary osteoarthritis by age was analyzed. The analysis showed a statistically significant deepening of EI syndrome in patients with PEI and primary osteoarthritis of older age, indicating the progression of pathologies in these patients with age (p<0,001). It was found that between most pairs in the correlation analysis there are statistically significant moderately strong correlation relationships, and between the level of a-elastase and MAM, с.u, at 254 significant correlation relationship (p<0,05).
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