Object of the study: the influence of combined treatment with inclusion of the drugs, which regulate lipid and calcium metabolism, on the clinical, laboratory (biochemical and immunological) indices in patients with postcholecystectomic syndrome (PCES) combined with essential hypertension (EH). Purpose of the study: improvement of the diagnosis quality of treatment efficacy for patients with PCES combined with EH. Methods of research: clinical, general laboratory, biochemical, immunological, radioimmunological, instrumental and statistic. Theoretical and practical results: a rational approach was developed to the complex therapy for patients with PCES combined with EH using a combination of atorvastatin (lipitin) and calcemine, thereby increasing the efficacy of the treatment. Novelty: clinical-pathogenetic peculiarities in the course of PCES combined with EH were revealed. It was proved that the combination of these diseases contributed to a rather frequent atypical course of the pain syndrome, a higher number of manifestations and a variety of dyspepsic and asthenoneurotic complaints, a more frequent occurrence of arrhythmiae. For the first time, negative changes in the calcium metabolism of patients with PCES were found out, and their expression rate reliably changed in cases of concomitant EH. New are the data about the state of lipid metabolism in patients with PCES combined with EH and revealing of their dependence upon the duration of the case history with cholelithiasis and EH; mechanisms of the formation of insulin dependence in such patients were described. It was proved that a combined course of PCES and EH contributed to a higher body mass index and the formation of the metabolic syndrome, it significantly aggravating the course of the both diseases. For the first time, a tactics of treating patients with PCES and EH was developed and substantiated, with use of a combination of atorvastatin (lipitin) and calcemine. A dynamics of clinical manifestations, functional state of the liver and pancreas in such patients was studied and it was proved that such a combination of the drugs produced positive effects on the immunological and biochemical indices of the diseases, namely, it caused restoration of the metabolic homeostasis and calcium metabolism imbalance, thereby increasing efficacy of the treatment. Degree of introduction: materials of the thesis were introduced into clinical practice of therapy and gastroenterology departments of city hospitals in Donetsk, Lugansk, Kyiv and Kharkiv. The scientific results obtained in the thesis are used in the teaching process at the Departments of General Practice – Family Medicine of Kharkiv State Medical University, Internal Medicine of Gorky State Medical University (Donetsk), Polyclinical and Family Medicine of Bogomolets National Medical University (Kyiv). Sphere of application: medicine, therapy.
