Sithinska I. Clinical pathogenic features and treatment of peptic ulcer of stomach and duodenum combined with hypertension and type 2 diabetes mellitus

The thesis presents a new approach to optimization of the treatment of patients with peptic ulcer of stomach and duodenum associated with toxigenic strains НР, combined with arterial hypertension and type 2 diabetes mellitus. It is grounded on the new scientific data on the clinical pathogenic features of the mentioned comorbide pathology and using of the combined probiotic simultaneously with anti-helicobacter therapy. There conducted an analysis of cagA і vacA НР genotype frequency, studied the clinical features and quality of life of the patients. The pathomorphological and histochemical specifics of stomach and duodenum lining are studied, the content of some cytokines (IL-6, IL-10, IL-12, IL-18) in blood serum is analyzed; there detected the changes of oxidant and anti-oxidant homeostasis, functional state of endothelium, hemocoagulation, fibrinolysis, proteolytic activity of blood plasma, as well as morphological and functional peculiarities of erythrocytes and lipid composition of blood in case of the mentioned comorbid pathology with infection of toxigenic (cagA+,vacA+) НР strains. It is proved that use of complex probiotic together with various anti-helicobacter schemes (standard triple therapy, quadrotherapу, sequence therapy "salvage therapy") in case of HP-associated peptic ulcer of stomach and duodenum, combined with arterial hypertension and type 2 diabetes mellitus is attended with upward trend of the parameters of cytokine profile, endothelium functional state, hemocoagulation and fibrinolysis, improvement of the effectiveness of HP-eradication, and improvement of morphological state of stomach and duodenum