Litvinov V. Optimization of treatment of patients with pemphigus taking into account indicators of oxidative stress and disorders of autonomic regulation

The dissertation work is dedicated to the optimization of treatment of patients with pemphigus taking into account indicators of oxidative stress and disorders of autonomic regulation. The results of the conducted research are based on the data of the complex study and subsequent dynamic observation of 47 patients with pemphigus vulgaris (30 of which constitute the main group, 17 - the comparison group), which have been inpatients of municipal institution "Regional Clinical Endocrine Dispensary" of Zaporizhzhia Regional Council. 20 almost healthy people, randomized by age and sex, have been examined as a control group. The frequency of registration and the nature of complications induced by continuous glucocorticoids consumption during treatment of patients with pemphigus vulgaris have been studied. The changes in biochemical indicators as well as hepatic functions in dynamics have been tracked by studying fat, carbohydrate and protein metabolism, the state of antioxidative protection system has been determined based on the nitric oxide and thiol-disulfide systems examination. The data regarding heart activity based on the results of 24-hour blood pressure monitoring, heart rhythm and ECG monitoring, as well as the state of autonomic nervous system, is presented in this work, the patients’ life quality has been tracked by questionnaire survey and calculation of clinical indicators of skin and mucosal damage amid the dermatosis development and systemic glucocorticoids treatment. The indicators, significant for the prognosis of pemphigus course and treatment efficacy have been determined. The indications and method of complex corrective therapy of patients with pemphigus including armadine have been established and introduced into healthcare practice, its effectiveness has been evaluated. Thus, theoretical justification and proposals of practical solution to the scientific task - optimization of treatment of patients with pemphigus based on the studying the pathogenetic role of nitric oxide metabolism, oxidative and nitrosative stress and thiol-disulfide system disorders with antioxidants deficiency development, as well as on determining the disorders of autonomic regulation, are presented in the work.