Ivaschenko L. Optimization of the treatment of patients with genital Chlamydіa trachomatіs infection taking into account a state of "L-arginine - nitrogen oxide" system and glycocalyx of the peripheral blood lympho

The object of study - urogenital chlamydiosis. The purpose of the study - to improve the efficiency of providing care to patients with chronic urogenital chlamydial infection based on clinical and epidemiological features of the disease and the protective and compensatory reactions. Methods: epidemiological, clinical, biochemical, immunological, electron microscopical, statistics. It is shown that the majority of patients with genital Chlamydіa trachomatіs infection are of reproductive age (25-35 years) - (43,9±4,1) %, half had STI [(49,3±4,1) %], and unprotected casual sexual contacts [(60,1±4,0) %] in their history. Rather chronic flow with absence of specific semiology [(64,2±3,9) %] and development of complications [(73,6±3,6) %] is attributed to the genital infection. Frequent accompanying Trichomonas vaginalis, Ureaplasma urealiticum and bacterial flora [(87,2±2,7) %], resistant to ceftriaxone and sensitive to levofloxacin take. An adaptive mechanisms at the level of metabolic and immune responses tend to decompensate, in particular, the functions of lymphocyte membranes and hole cell (61,1 %). The study of "L-arginine - nitrogen oxide" system in circulating blood and lymphocytes is shown the activation of processes of is free-radical oxidation which leads to destabilization of membrane glycocalyx, invoking cytotoxic damage of lymphocytes. Transmission electronic microscopy reveals destruction of membrane glycocalyx of lymphocytes. The effective treatment of genital Chlamydіa trachomatіs infection with use of an antibacterial drug (levofloxacin), and also metabolic (biotin) and immune (interferon) therapy is proposed. The new mode of treatment is more effective [(97,7±1,6) %] in comparison with traditional therapy [(88,5±4,1) %]. The frequency of side effects is reduced with (14,8±4,1) % to (3,4±2,0) % accordingly. Results have been implemented in the practice of the clinic of SE "Institute of dermatology and venerology of NAMS of Ukraine", Kharkiv regional clinical dermato-venerological dispensary number 1, Donetsk regional dermato-venerological dispensary, Dnipropetrovsk regional dermato-venerological dispensary and Poltava regional clinical dermato-venerological dispensary. Use area - dermatovenerology.