Trishch V. Speciality of macro- and microelemental status in patients with chronic nonbacterial prostatitis and its correction

Dissertation is dedicated to improvement of diagnostics and treatment of the patients with chronic nonbacterial prostatitis (CNP) using complex study of specialties of the macro- and microelemental metabolism, immune status, antioxidant defense, state of endothelial function and reasoning of offered complex therapy schemes with proving of their effectiveness. It was found a reliable insufficiency in blood and ejaculate of the patients with CNP contents of Zinc, Magnesium, Iron and increase of Copper. More expressed for Zinc it was in cases of ICPPS, and -for Magnesium and Iron - NCPPS. Level of Copper was reliably higher in biomaterials of patients with ICPPS. Intensity of changes in bioelemental status obeys the duration of the disease. Except it, it is more clearly seen after results of their determination in blood, which is important for clinical practice. It is proved, that disbalance in system of macro- and microelements is one of pathogenetic mechanisms of CNP development and progression. There were marked changes in system of antioxidant defense in this category of patients, which are more visible in patients with ICPPS and get worse in cases with long duration of disease. It was found direct correlation between contents in blood of Zinc and reverse between Copper and level of antioxidant enzymes. It was observed a reliable increase of proinflammatory cytokines in blood of patients with CNP, to a greater extent in patients with ICPPS. There were marked violations of endothelial function, especially in patients with NCPPS. It was proved a diagnostic value of endothelin-1 determination in patients with CNP. There were suggested improved schemes of treatment of patients with CNP with use of polyelemental complex, L-arginin and interferon alpha-2b in different varieties additionally to the basic therapy, with purpose of treatment effectiveness improvement. Inclusion of mentioned medications allowed to provide an optimal correction of diselementosis, to level an action of oxidant stress, improve endothelial function. It was proved аn efficiency and safety of their use in recommended doses, with simultaneous increase of treatment effectiveness, what appeared in improvement of patients' life quality (according to IPSS system) on 79,4% and 77,7% respectively by ICPPS (cat. IIIA) and NCPPS (cat. IIIB).