Melnyk N. Clinicopathogenetic peculiarities of chronic pancreatitis in combination with ischemic heart disease, оptimization of treatment and rehabilitation.

The object of study: lipid metabolism, secretory pancreatic function, trophological status, pro- and antioxidant system, general and specific proteolysis, and quality of life in 90 patients with chronic pancreatitis in combination with stable coronary heart disease and 34 patients with chronic pancreatitis. The aim of the study: to develop optimized treatment and complex rehabilitation programs for patients with chronic pancreatitis in combination with coronary heart disease on the basis of the analysis of clinical and pathogenetic features including the use of medicated and non-medicated means in the program of complex correction of the condition for such patients. Methods: clinical anamnestic; anthropometric - body mass index, shoulder muscle extent, skin-fat fold over triceps, laboratory - number of red blood cells, hemoglobin level, biochemical - blood glucose, total protein, total cholesterol, triglycerides, total lipids, malonic aldehyde, SH-groups, superoxide dismutase, catalase, ceruloplasmin, plasma proteolytic activity, kallikrein, prekallikrein, proteinase inhibitor, macroglobulin, kininase-II activity, immuno-enzymatic - fecal elastase-1, instrumental - ultrasound examination of the pancreas, sociological - questionnaire, statistics. Scientific novelty of the results: for the first time, the dependence of the imbalance of lipid homeostasis on the depth of disorders of the exocrine function of the pancreas in chronic pancreatitis in combination with stable ischemic heart disease has been proved. For the first time, the existence of interdependencies between lipid metabolism, general and specific proteolysis, lipid peroxidation - antioxidant system and manifestations of trophological insufficiency was confirmed. For the first time, the effectiveness of complex medical and rehabilitation programs of medical correction of the revealed disorders in patients with comorbid course of chronic pancreatitis and stable coronary heart disease with the use polyunsaturated fatty acids and meldonium with the course of meldonium-electrophoresis.