OA Ivchenko, IE Naidenov, SSMU, EDO, Tomsk
Obliterative disease of the arteries, despite the significant achievements in modern angiosurgery occupy a leading place in the structure of morbidity and mortality in developed countries (Pokrovsky AV, 1980, Kniazev MD, 1980). Cause of chronic occlusive diseases of abdominal aorta and its branches in 85-90% of cases is atherosclerosis (Saveliev VS, 1970, Gavrilov, DC, 1984). Ongoing atherosclerotic process forms a so-called "high-rise" stenosis and occlusion, including the arteries of the heart, brain, internal organs of the abdominal cavity (Yakushin GA, 1990; Belov YV, 1991). Atherosclerotic process, progressing in the body of patients, often reduces the "out" the results of surgical treatment (Pokrovsky AV, 1998). In patients with obliterating diseases of lower limb arteries are already in the second degree of ischemia, the activation of both platelets and coagulation homeostasis, emerging against the backdrop of depression, anticoagulation and fibrinolytic potential. In these patients revealed a distinct depression most of the indicators anticoagulation management (Baluda VP, et al., 1980). With progression of ischemia grow fibrintrombotsitarnoy density structure of the bunch, and depression of fibrinolytic activity. Studies in the "functional tests" revealed more than half of patients with critical ischemia of the degree of reduction in reserve capacity of the hemostatic system in the form of decompensated type of reaction and the transition probability of chronic DIC in the subacute form, which can significantly complicate the main process. Taking into account the results obtained by this patient is shown Correcting therapy of hemostasis, aimed at improving blood rheological properties for the treatment of latent phase giperkoagulyatsionnoy DIC. According to existing concepts, the basic principle of antithrombotic therapy in tromboopasnyh situations should be a complex effect on the pathological changes at all levels of the hemostatic system.
The presence of patients resistant to medical treatment, dissatisfaction with the results of correction tromboopasnosti occlusive atherosclerosis, a contradiction in matters of antithrombotic therapy allowed to offer a comprehensive introduction to the method of therapy with a course of treatment of biologically active additives (BAA). Treated 25 patients with varying degrees of ischemia (2-4) with occlusive diseases of lower limb arteries. These patients, depending on the methods used antithrombotic therapy were divided into two groups. In the first (control) group included 12 patients, the second (main) included 13 patients. All patients in the control group were injected trental, reopoliglyukin, Actovegin. In the second group to the above treatment was administered biologically active food supplements company ART LIFE: VITAMIN "E" 1 capsule 2 times daily enzyme complex plus 1 tablet 3 times a day, NEYROSTRONG 1 tablet 3 times a day. The course of treatment was 18 days. After completion of treatment in 8 patients (66%) of the control group noted the disappearance of pain in his foot, warming the extremities, increased exercise tolerance, increased distance and duration of the walk without intermittent claudication. The other four had no noticeable improvement.
In the study group, where in the complex treatment were additionally included dietary supplements, 11 patients (84%) reported disappearance of pain in his foot, warming the extremities, increased exercise tolerance, increased distance and duration of the walk without intermittent claudication. Two patients with no improvement noted.
In the study of hemostasis in patients with decompensated type of reaction statistically significant changes did not receive any of the groups. Other information recorded in patients with compensated type of reaction. In the control group 3 of the observed (25%), according to the coagulation had a statistically significant change in APTT (reduced by 15-20%) in the main group 9 patients (73%) for this indicator had a statistically significant change. In the same group in 7 patients (53%) showed a significant decrease in platelet aggregation by 60-65% and significant activation of fibrinolysis.
1.B depending on the degree of ischemia, patients with okklyuzionntmi diseases of lower limb arteries are two types of reaction to the "cuff test": dekompeisirovannuyu and compensated.
2.Primenenie dietary supplements, either alone or in combination was shown in patients with occlusive arterial disease of lower extremities, having compensated type of reaction to "cuff test."
3.Predlozhennaya methodology for integrated use of dietary supplements ART LIFE is effective not only for correcting disorders of hemostasis, but also for prolonging the remission of clinical symptoms.