Method for the diagnosis of individual indications for essentiale

 

(57) Abstract:

The invention relates to medicine, in particular to pharmacology and Hepatology. The method allows to increase accuracy and make it easier to diagnose individual indications for Essentiale. Spend the identification of specific pathological conditions in the serum is measured relative content of phosphatidylcholine and digital values below 40% of the diagnosed individual need to the appointment of Essentiale in a particular patient.

The invention relates to medicine, namely to pharmacology and Hepatology.

The active principle Essentiale - diglyceride esters holinesterzoy acid of natural origin with a predominance of polyunsaturated fatty acids, mainly linoleic about 70%, linolenic acid and linoleic acid (Reference VIDAL, "drugs in Russia", 2002, p. B-733). That is, the drug Essentiale is a phosphatidylcholine-enriched polyunsaturated (essential) fatty acids and transformed into polyenylphosphatidylcholine (EPL). It contains linoleic acid in the 1 and 2 positions. The most active component of EPL (>50%) - 1,2-divinelyinspired (St membrane therapy of the liver. Mat. proc. "Essential phospholipids in the treatment of liver lesions". - M - 1997. - S. 9).

The closest to the technical nature of the claimed is a method of diagnosis of testimony to the appointment of Essentiale by pre-identifying patient specific pathological conditions, such as fatty degeneration of the liver of various etiology, acute and chronic hepatitis, cirrhosis, liver cell necrosis, hepatic coma, hepatic toxicity, toxicosis of pregnancy, pre - and postoperative treatment, psoriasis, radiation syndrome (Handbook VIDAL, "drugs in Russia", 2002, p. B-733) (prototype).

However, for the qualitative diagnosis of each of the above pathological conditions requires several days. Most importantly, do not take into account the level of phosphatidylcholine in a particular patient. For example, it is known that in patients with mild hepatitis is observed that elevated levels of total phospholipids and, accordingly, phosphatidylcholine (Lifshitz C. M., Sidelnikov C. I. Biochemical tests in the clinic. Directory of e 2-that is, Publishing house of Voronezh state University, 1996, S. 97), and additional injection of phosphatidylcholine is not required. There is compelling data (Y. N. Mellowtone. Diss. ... candles. the honey. Sciences. L., 1986, S. 9), indicating that ordinary patients with acute viral hepatitis And observed increased levels of phosphatidylcholine, and abused alcohol reduction, which is the indication for Essentiale. In chronic hepatitis and cirrhosis of the liver is not always feasible to assign Essentiale, as contained in the drug phosphatidylcholine and without elevated compared to normal in carriers of HBSAg alcoholics, patients with chronic hepatitis and liver cirrhosis (Makarov, C. K. Phospholipid spectrum of blood serum at different stages of combined viral and alcoholic liver disease. In EXT. : Clinical perspectives in Infectology. Proc. Dokl. The age of three. The scientific. Proc. dedicated to the 125th anniversary of the birthday of Professor N. To.Rosenberg and the 105th anniversary of Department. INF. B-her VMA. SPb, 2001, S. 127). Among patients with alcoholism, there are persons with a high level of phosphatidylcholine, which is Essentiale not shown, and persons with low levels of phosphatidylcholine, i.e. that the drug not only shown, but necessary (Makarov, C. K., Kargapolov A. C.//Lipid composition of the blood serum of patients with alcoholism and chronic persistiruuschem is the level of phosphatidylcholine in a particular patient, it is necessary to consider the possible individual variations in the level of phosphatidylcholine and fluctuations in these pathological conditions.

In the claimed invention solved the problem of the increased accuracy and simplify the diagnosis of testimony to the appointment of Essentiale and increase the effectiveness of treatment.

The technical result is the determination of the level of phosphatidylcholine, which shows the introduction of Essentiale.

This technical result is achieved by a method for the diagnosis of testimony to the appointment of Essentiale, including the identification of specific pathological condition, characterized in that in the serum is measured relative content of phosphatidylcholine and digital values below 40% diagnose the need for the appointment of Essentiale in a particular patient.

Studies have shown that most patients with acute and chronic viral hepatitis and cirrhosis of the liver observed increased levels of phosphatidylcholine, i.e. supplementation in the treatment of phosphatidylcholine in the medication Essentiale without determining the level of phosphatidylcholine in the serum makes no sense. In practice, when treating pain who were Visalia levels of bilirubin and transaminases. Some authors observed a lack of therapeutic effect of Essentiale in the treatment of patients with acute viral hepatitis b (L. D. Levin, L. M. Mkhitaryan, R. A. Trapezounta. On the application of Essentiale in acute viral hepatitis C. //Clinical medicine. - 1988. - 5. - S. 94).

New, previously unknown features of the claimed method for the diagnosis of testimony to the appointment of Essentiale are:

1. using an objective test, that is, the determination of the content of phosphatidylcholine in serum for the diagnosis of individual indications for Essentiale;

2. developed and proposed levels of phosphatidylcholine, below which the diagnosed individual indication for Essentiale.

The method was developed on the basis of the analysis of the level of phosphatidylcholine in phospholipid spectrum (lipid profile) serum in 80 patients with alcoholism, 40 patients with acute viral hepatitis, 50 patients with chronic viral hepatitis who abused alcohol, 40 media HBSAg alcoholism, 30 patients with chronic viral hepatitis, 20 cirrhotic patients and 40 healthy persons.

Phospholipid spectrum is composed of lysophosphatidylcholine (LFH), lithosphere is attached, the vast majority of healthy people, the level of the relative content of phosphatidylcholine in phospholipid spectrum of the serum is in the range from 34 to 40%. The relative content of phosphatidylcholine in the majority of patients with alcoholism were 23-29%, and in patients with acute and chronic viral hepatitis who abused alcohol as well as carriers of HBsAg, alcoholism, often below 40%. However, in patients with chronic viral hepatitis without alcohol abuse history and patients with cirrhosis level relative content of phosphatidylcholine in phospholipid spectrum of blood serum only in rare cases was below 40%.

The proposed method for the diagnosis of alcohol abuse is carried out in the following sequence.

Numerical values of the relative content of fractions phosphatidylcholine in the composition of the phospholipid spectrum of lipid determined by conventional, well known methods (Kargapolov A. C. Analysis of the lipid composition of mitochondrial and endoplasmatic membranes using the method of horizontal flow chromatography. // Biochemistry. - 1981. - So 46. - 4. - S. 691-698; Makarov, C. K., Kargapolov A. C. Lipid composition Syv="ptx2">

Get the content of phosphatidylcholine in phospholipid spectrum of blood serum and its values below 40% diagnose indication Essentiale.

Example 1. Karmali A. I., 40 years, history 82, patient alcoholism stage II with binge drinking with increased tolerance. In the composition of lipid serum content of phosphatidylcholine was 32.5 per cent. Digital level value of phosphatidylcholine below 40% was an indication for Essentiale. There was obtained a positive effect.

Example 2. Anikin, A. N., 54 year history 11. The diagnosis of alcoholism stage II with increased tolerance. In phospholipid spectrum of lipid serum content of phosphatidylcholine was 37.4 per cent. The digital value of phosphatidylcholine below 40% was an indication for Essentiale. As a result of treatment by a preparation "Essentiale" was given a positive clinical effect and the increase in the content of phosphatidylcholine lipid profile.

Example 3. Patient Alekseev A. C., 35 years old, medical history, 2315, was admitted to the infectious diseases clinic with a diagnosis of acute viral hepatitis. In phospholipid spectrum of lipid serum content of phosphatidylcholine, sotetel received positive clinical effect.

Example 4. Kuznetsov, C. I., donor blood. Abusing alcohol. In phospholipid spectrum of lipid serum content of phosphatidylcholine was 35%. The digital value of phosphatidylcholine below 40% was an indication for a table.

Example 5. Sadowski, S. C., 20 years history 1072. Was in the infectious Department with a diagnosis of chronic viral hepatitis C. In phospholipid spectrum of lipid serum content was 47.2 percent. The digital value of phosphatidylcholine was above 40% and is not an indication for Essentiale.

Example 6. Izotov, A. A., 28 years old, medical history, 95, media HBSAg patient alcoholism in stage II with increased tolerance. In phospholipid spectrum of lipid serum content of phosphatidylcholine was 33%. The digital value of phosphatidylcholine below 40% was an indication for Essentiale. There was obtained a positive effect.

Example 7. Andreev, A. N., 52 years history 237. Were treated in the medical ward with a diagnosis of miloslava cirrhosis of the liver. The admission to the hospital was preceded by a bout during the week to use up to 1 liter of vodka a day. In the phospholipid specn below 40% was an indication for Essentiale. The drug was injected intravenously and by mouth. Was given a positive clinical effect.

This method is simple in execution, able to objectively prove the need as a remedy drug containing phosphatidylcholine Essentiale that will provide quality therapeutic effect. Accurate diagnosis indications for Essentiale can increase the quality of treatment to avoid side effects and complications, as well as to monitor the effectiveness of Essentiale in the treatment process.

Method for the diagnosis of individual indications for Essentiale, including the identification of specific pathological condition, characterized in that in the serum is measured relative content of phosphatidylcholine and digital values below 40% diagnose the need for the appointment of Essentiale in a particular patient.

 

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