Vlasenko H. Diagnostic and prognostic significance of calcium metabolism disorders in patients with chronic acalculous cholecystitis accompanied by essential hypertension and methods to correct them

The work is devoted to investigation of the characteristics of the clinical course of chronic acalculous cholecystitis (CAC) against a background of essential hypertension (EH) with consideration of the type of gallbladder dyskinesia, Oddi's sphincter state and EH stage. The changes in the parameters of calcium metabolism, the system of antioxidant protection, lipid peroxidation, nonspecific immunity and anti-inflammatory cytokines were studied. The efficacy of differentiated therapy was assessed. The study involved 102 patients with CAC accompanied by EH aged 24-56 with the disease duration ranging from 5 months to 21 years. The patients were followed up for 2.5 years. Negative prognosis predictors, i.e. presence of the changes in of total and ionized blood serum calcium amount as well as relative values of these parameters, were revealed. Combination of CAC and EH was shown to be characterized by accumulation and aggravation of the clinical manifestations due to crossing of the pathogenetic links ofthe diseases. Differential therapy administration, namely Duspataline, nettle tincture and Calcemine in gallbladder hypertone and Metochlopramide, Choliver and Calcemine in hypotone, facilitates improvement of clinical and laboratory signs of the diseases. It was also established that arterial pressure correction should be done with consideration of Oddi's sphincter state: in hypertone Corinfar Retard should be administered, in hypotone - Berlipril.