Drapak O. Clinical and pathogenetic features and medical rehabilitation of patients with chronic pancreatitis in combination with essential hypertension

The thesis is dedicated to improving the quality of diagnosis, treatment efficiency and improvement quality of life in patients with chronic pancreatitis (CP) in combination with essential hypertension (EH) during medical rehabilitation in practice of general practitioner. It was found that due to the long course and progression of chronic pancreatitis quality of life for patients reduces, trophological insufficiency develops and deepens. Trophological insufficiency manifests as violations of nutritional status, anemia, lipid imbalance, osteopenia, which are worsen in case of concomitant EH. The pathogenetic mechanisms of the trophological insufficiency forming in patients with СР and EH were detected. The negative effects of hypertension on the course of CP, including the severity of exocrine pancreatic insufficiency, the frequency and intensity of the major clinical syndromes of CP, quality of life and laboratory parameters of patients, as well as individual features of the trophological status were proved. Negative influence of the elevated blood pressure on the protein status (total protein, hemoglobin level) and mineral metabolism (osteopenia degree) in patients with СP and EH was proved. The relationships between hemodynamic parameters of hypertension, level of NO2-, cytokines, malonic aldehyde, compounds of the antioxidant protection systems and trophological status in patients with CP and EH were established. The expediency of L-arginine aspartate oral forms and acupuncture usage in the rehabilitation of patients with CP and EH due to their positive effects on hemodynamics, endothelial function, antioxidant protection systems, cytokine profile, trofological status of patients and due to improvement patient's quality of life and clinical course of the comorbidities was proved.