Судинорухова функція ендотелію при гастродуоденопатіях, індукованих нестероїдними протизапальними препаратами, у хворих на остеоартроз

Abstract

У статті наведені результати дослідження судинорухової функції ендотелію при гастродуоденопатіях, спричинених нестероїдними протизапальними препаратами, у хворих на остеоартроз. На підставі результатів дуплексного сканування плечової артерії було виявлено порушену ендотелійзалежну та ендотелійнезалежну вазодилатацію у обстежених хворих. Було встановлено істотніші порушення функціонального стану ендотелію за умов супутньої Helicobacter pylori.

В статье представлены результаты обследования сосудистодвигательной функции эндотелия при гастродуоденопатиях, индуцированных нестероидными противовоспалительными препаратами, у больных остеоартрозом. На основании результатов дуплексного сканирования плечевой артерии было установлено нарушение эндотелийзависимой и эндотелийнезависимой вазодилатации у обследованных больных. Было установлено существенные нарушения функционального состояния эндотелия в условиях сопутствующей Helicobacter pylori.

Osteoarthrosis is an acute medical and social problem resulting in temporary incapacity to work, disability and significant lowering of patients' life quality. As of today the main method of osteoarthrosis treatment is use of nonsteroidal anti-inflammatory drugs. According to the references 46.5 % of side effects in Ukraine are the result of nonsteroidal anti-inflammatory drugs use. Gastric erosions and ulcers induced by nonsteroidal anti-inflammatory drugs use are one of the most frequent causes of admission to in-patient surgery and gastroenterology departments in Europe and the USA. That is why study of some pathogenetic action mechanisms leading to gastroduodenopathy development caused by nonsteroidal anti-inflammatory drugs use in case of patients with osteoarthrosis is topical for modern medicine. The object of this study was to determine endothelium vasomotion function in case of gastroduodenopathy induced by treatment of patients with of osteoarthrosis by nonsteroidal anti-inflammatory drugs. Materials and Methods. 50 patients were examined for osteoarthrosis with concomitant gastroduodenopathy induced by nonsteroidal antiinflammatory drugs use. The patients’ distribution has been performed irrespective of Helicobacter pylori presence and/or alimentary tube affection degree. All patients underwent fibrogastroduodenoscopy with targeted biopsy performed by the standard technique using fibrogastroduodenoscopy device “Olympus” in order to diagnose gastroduodenopathy. The presence of Helicobacter pylori has been determined by means of invasive express analysis of urease tissue activity using diagnostic sets Helpil®-test (“AMA”, Saint Petersburg), morphologic tests (using azurII-eosin stain) as well as by means of immunochromatographic Helicobacter pylori antigen faeces test (CerTest Biotec, S.L., Spain, “Pharmasco”). Vasomotion endothelium function has been studied by means of duplex ultrasonic scanning of brachial artery. Discussion. 70 % of patients with concomitant gastroduodenopathy induced by nonsteroidal anti-inflammatory drugs use were diagnosed with insufficient vasodilation. For instance, 46 % of patients under examination were diagnosed with insufficient vasodilation, 24 % of persons under examination were diagnosed with paradoxical vasoconstriction. It is to mention that endothelium shear stress and endothelium shear stress sensitivity during reactive hyperaemia test was decreasing more apparently in case of patients with concomitant Helicobacter pylori infection. Obtained results indicate development of endothelial dysfunction of patients with osteoarthrosis in case of gastroduodenopathy induced by nonsteroidal anti-inflammatory drugs use. Concomitant Helicobacter pylori resulted in significant dysfunction of endothelium of patients with osteoarthrosis with gastroduodenopathy induced by nonsteroidal anti-inflammatory drugs use