Cherkas A. The peculiarities of aerobic metabolism and heart rate variability in patients with duodenal peptic ulcer, associated with Helicobacter pylori, combined with neurocirculatory dystonia under the influence of amaranth oil

The object of the study is the duodenal peptic ulcer (DPU), associated with Helicobacter pylori, accompanied by neurocirculatory dystonia (NCD). The aim is to improve the efficiency of DPU treatment by the means of amaranth oil (AO) based on the clarification of the peculiarities of clinical, morphological parameters, aerobic metabolism and heart rate variability (HRV) indexes. Methods - laboratory, biochemical, electrophysiological, esophagogasroduodenoscopic, histological, immunohistochemical, statistical. The novelty of the research: the efficiency of aerobic metabolism correction by AO and improvement of gastric mucosa (GM)recovery after H. pylori eradication and increase of HRV. The dynamics of accumulation and distribution of 4-hydroxynonenal (HNE)-histidine adducts in GM in patients under the influence of AO by the means of immunohistochemical semiquantitive and qualitative examination. For the first time the correlations between parameters of aerobic metabolism and parameters of HRV and their changes after standard and treatment including AO were determined. The results - in healthy volunteers we determined some accumulation of HNE in cytoplasm of gastric glandular cells in antrum (100,0%) and corpus of stomach (95,0%) not related to H. pylori status. The grade of immunopositivity in control group did not differ significantly from H. pylori positive patients (p>0,05 by Mann-Whitney U-test). Immunopositivity of lamina propria is related to H. pylori contamination and persistence of inflammatory cells. H. pylori eradication leads to normalization of inflammatory signs, however oxidative stress marker HNE persists after standard treatment. AO decreases significantly accumulation of HNE (p<0,05) and improves recovery of GM to normal condition. The parameters of HRV in patients were significantly lower comparing to control group (TP in supine position lower by 46,1% and SDNN by 28,0%). After standard treatment these parameters further decrease (by 45,7 and 27,2% respectively). The redistribution of spectral parameter of HRV, decrease of HFand relatively high level of VLF-waves. Prescription of AO provided increase in TP by 21,3% and SDNN by 5,1%, and relative increase of HF-waves. The correlations of HRV and aerobic metabolism parameters (most significant of catalase with RMSSD, pNN50 and HF, p<0,05) were observed. In control group such dependencies were not observed. After use of AO the qualitative changes of correlations were observed. Positive significant correlations of HRV parameters switched to negative with TBARS level. The results were introduced in practice of medical institutions, scientific and educational processes. The field is medicine.