The dissertation is devoted to the problem of increasing the effectiveness of prevention and treatment of diabetic retinopathy in patients with type 2 diabetes by clinical and immunological basis of the use of arginine and antioxidants.
The problem of diabetes is very relevant today, as this disease affects more and more people every year, regardless of gender, age and lifestyle. In the early stages of development of diabetic retinopathy (DR) there is no marked change in visual acuity, and therefore patients do not go to the doctor. One of the successful decisions to treat retinal changes in type 2 diabetes is the use of antioxidant and anti-inflammatory drugs.
It was found that the content of lymphocytes in patients with diabetes in the presence of DM was higher than healthy subjects by 22,5 % (p < 0,01). The content of CD3 + cells in patients with CD and DM was lower than the control group data by 20,0 % and 25,7 % (p < 0,01), CD8+lymphocytes by 17,4 % (p < 0,01) and 31,2 % (p < 0,01), CD19 + lymphocytes were higher by 29,7 % and 2,03 times (p < 0,01), the immunoregulatory index exceeded the values in 3 and 1,54 times (p < 0,01), CD25 + cells exceeded the values by 33.3 % (p < 0,01) and 2,1 times (p < 0,01), HLA-DR + lymphocytes were higher by 43.5 % and 1,85 times (p < 0,01), CD95 + lymphocytes were increased by 2,5 times (p < 0,01) and 4,1 times (p < 0,01), CD54 + lymphocytes were higher by 1,8 times (p < 0,01) with DR.
Extended scientific data on the features of immunity disorders in nonproliferative DR in patients with type 2 diabetes. The stimulated FSH proliferative activity of lymphocytes in patients with DM was lowered (p < 0,01) by 12.6 % compared with healthy subjects, spontaneous proliferative activity of lymphocytes was higher in 1,7 times (p < 0,01), IgG content in blood serum was higher by 27,8 %, and IgA was lowered 1,6 times (p < 0,01), the level of a high CIC was 1,6 times lower, and the median-molecular level was higher by 1,2 times, Pathogenic small size - higher in 2,9 times (p < 0,01). The level of TNF-α in patients with diabetes mellitus was higher (p < 0.01) of control group values by 49.9 %, and in the second - by 2,3 times.
Extended scientific data on the features of immunity disorders in nonproliferative DR in patients with type 2 diabetes. In patients with diabetes mellitus type 2 with DR, the content of TNF-α is higher than in healthy subjects 2,66 times and 32,9 % higher than in the comparison group (p < 0,05); IL -1β - in 2,65 times and 21,9 % (p < 0,05); IL-6 - in 6,33 times and in 2,95 times (p <0,05); IL-8 - in 5.67 times and 2.34 times (p <0.05); TGF-β in 2.54 times (p <0.05) and 1,87 times (p < 0,05) respectively. The level of spontaneous production of TNF-α was higher than that of the comparative group of 41,01 % (p < 0,05), IL-1β - by 32,8 % (p < 0,05), IL-6 - by 25,1 % (p <0,05), IL-8 - by 24,3 % (p < 0,05), TGF-β by 75,8 % (p < 0,05), and IL-4 - lower at 28,6% (p < 0,05).
Extended scientific data on the features of immunity disorders in nonproliferative DR in patients with type 2 diabetes. In patients with DM and CD95 + lymphocytes - in 2,82 times (p <0,05). The level of soluble vascular adhesion molecule sVCAM in the main group exceeded the data in the comparison group by 24,26 % (p < 0,05), and sІCAM-1 - by 21,75 % (p <0,05).
Supplemented scientific data on the influence of ethylmethylhydroxypyridine succinate on immunity parameters in patients with NRAD and type 2 diabetes. His application significantly reduces the level of spontaneous RBTL by 15,77 % (p <0,05), the level of pathogenic mid-size (11-19S) CICs is by 16,22 % (p < 0,05) and small (<11S ) - by 18.95 % (p < 0,05), while simultaneously increasing the concentration of physiological CICs of a large size (> 19S) by 26,47 % (p < 0,05), reduces the levels of TNF-α - by 43,4 % (p < 0,05), IL-1β - by 40,68 % (p < 0,05), IL-6 - by 28,78 % (p < 0,05), TGF-β by 47,26 % (p <0,05), and also increases the concentration of IL-4 by 30,11 % (p < 0,05).
A new method of prevention and treatment of NPDR in type 2 diabetes, which consists in the use of arginine and antioxidant amino acids against the background of traditional conservative treatment, has been developed and introduced into practice, which made it possible to improve after the first course by 26,7 % and 36,2 % after the second course (p < 0,05).
A new method of prevention and treatment of NPDR in type 2 diabetes was developed and introduced into practice, consisting of the use of amino acids of arginine and antioxidants on the background of traditional conservative treatment, which allowed to increase the rate of CFFF by 8 % 6 months after the first course of treatment and by 9 % 6 months after the second course of treatment compared with the treatment before treatment, the addition of ethyl methylhydroxypyridine succinate by 7 % and 9 %, adding a combination of these drugs by 10 % and 14 % respectively (p < 0.05).
