Tolstykova T. The peculiarities of functional and metabolic disorders, and their correction in patients with duodenal peptic ulcer combined with chronic cholecystitis and adiposity.

Object of the study: The functional state of the stomach and biliary system, lipid metabolism, oxidation homeostasis and metabolic activity of neurohumoral regulation in patients with of DPU (duodenal peptic ulcer) associated with CAC (chronic acalculous cholecystitis) and obesity. Purpose of the study: To optimize the treatment of DPU associated with CAC and obesity with the consideration of the functional and metabolic disorders. Methods of the investigation: Clinical, anthropometry, instrumental (esophagogastroduodenoscopy, sonoscopy, ECG), functional (gastric and duodenal probing), biological rhythms study, statistical. Theoretical and practical results: The practical significance of the work consists in a complex of methodological measures which allow to improve the diagnosis of the state of the stomach as well as to assess the oxidation stress using the types of AOS reaction. Novelty: It was established that the course of DPU and CAC with obesity is accompanied by mutually aggravating influence: disorders of lipid metabolism and their peroxidation at reduction of controlling function of the neurohumoral system support the inflammatory process in the gallbladder and the mucous membrane of the EGD zone. The concept of evaluation of the state of oxidation homeostasis based on the model of Selier stress-syndrome was further developed. For the first time the types of endogenic antioxidant system reception to excessive production of malonic dialdehyde were distinguished in patients with of DPU associated with CAC and obesity: mobilization, compensation, rigid, decompensation. Their influence on the development of functional and morphological changes on the EGD zone organs and biliary system was established. It was determined that only rigid and decompensation types of AOS reaction are accompanied by severe disorders in the digestive system caused by insufficient adaptation-trophic function of the sympathoadrenal system and serotoninergic link of regulation. For the first time, discrepancies in the mechanisms of disorders of redox processes in patients with DPU associated with CAC and obesity depending on the body mass were revealed. For the first time, a differentiated approach to treatment of DPU associated with CAC and obesity with the con-sideration of the types of AOS reaction and the functional changes in the stomach and biliary system was substantiated. Degree of introduction: The suggested methods of diagnosis were introduced to the work of stomach and duodenum disease department of Institute of Gastroenterology (Academy of Medical Sciences of Ukraine), gastroenterology department of hospital No. 6 (Dnepropetrovsk), therapy department of Central District Hos-pital of Dnepropetrovsk district, therapy department of hospital of Nizhnedneprovsk-uzel station (Pridneprovsk Railroad), phyto-therapy department with a course of pharmacology of Medical In-stitute of Ukrainian Association of Falk Medicine (Kiev), gastro-enterology department of Institute of Therapy (Academy of Medi-cal Sciences of Ukraine), therapy department of City Hospital No. 10 (Zaporozhie), therapy department of City Clinical Hospital No. 1 (Poltava). The findings of the research are used in the teaching process of department of therapy (Odessa State Medical Univer-sity). Sphere of application: medicine, gastroenterology.