Semenova I. Clinical and pathogenetic predictors of osteodeficiency formation in patients with chronic pancreatitis: ways of optimization, correction and prognostication.

Object of study: osteodeficiency, secretory function of the pancreas, trophological status and quality of life of 115 patients with chronic pancreatitis. The aim of the study: optimization of diagnosis and complex treatment of chronic pancreatitis by assessing the clinical and pathogenetic features of osteogenic changes and their correction when incorporating medical methods. Methods of research: clinical-anamnestic - for the evaluation of clinical manifestations of chronic pancreatitis with osteodeficiency and the study of etiological factors of the disease; instrumental: two-photon X-ray densitometry - for determining the mineral density of bone tissue in patients with chronic pancreatitis, ultrasound examination of the pancreas - for the detection of structural changes in the pancreas in chronic pancreatitis; biochemical - blood glucose, Ca, P, Mg - to assess the state of carbohydrate and mineral metabolism, the level of endogenous intoxication - to study the influence of endotoxicosis on the course of chronic pancreatitis with osteodeficiency; immuno-enzymatic - fecal ?-elastase - to evaluate the external secretion function of the pancreas; sociological - questionnaires on the international scales SF-36 and GSRS - for assessing the quality of life indicators; statistical - for the purpose of mathematical processing of the obtained results. Scientific novelty of the results: The dissertation examines the clinical and pathogenetic mechanisms of the osteopathy formation osteopathy in patients with CP and develops comprehensive programs for their correction, treatment and rehabilitation of patients based on a comprehensive clinical-laboratory and instrumental examination. New data on the state of bone tissue mineral density in patients with CP were obtained based on data from two-photon computer densitometry and mineral metabolism indices. The relationship between the degree of osteodephritis and the depth of the external secretion insufficiency of the pancreas in terms of fecal elastase was studied in depth, as well as correlations with changes in the coprogram and US-criteria were determined. New data on the factors of the formation and deepening of osteodeficiency at CP were obtained. For the first time, prognostic models of the T level at CP were developed. Dependence of the parameters of the state of bone mineral density during CP was studied deeply from the indices of vitamin-mineral metabolism and the index of degradation of the connective tissue of oxyproline. New data on the level of endotoxicosis in patients with concomitant osteodeficiency were obtained. For the first time, the effectiveness of the inclusion of calcium with vitamin D3 in the complex treatment of CP with concomitant osteodeficiency has been established. For the first time, the effectiveness of the use of risedronic acid in the complex and rehabilitation of patients with osteoporosis was studied.