A method of treating pseudotumor orbit
(57) Abstract:The invention relates to medicine, in particular to ophthalmology, and can be used in the treatment pseudophoenix diseases of the orbit. To do this, hold corticosteroid therapy in the form of retro-bulbar injection drug glucocorticoid number and enter bromantan 0.05 1 g once daily for 3 days with a total duration of treatment of 18.53.6 days. The proposed method of treatment leads to long-term stabilization process with elimination of clinical symptoms due to the correction of the basic pathogenesis of the disease. The invention relates to medicine, in particular to ophthalmology, and can be used in complex treatment of pseudotumor orbit.It is known that one of the most effective and widely popular methods of treatment of pseudotumor orbit is systemic or local therapy with corticosteroids; such treatment is protracted and not always possible to achieve complete stabilization process with elimination of clinical symptoms. One of the reasons for incomplete medical rehabilitation and recurring relapses pseudocoarctation drugs (formation of steroid dependence and steroidantibiotic forms of the disease with residual edema periorbital tissue, activation of autoimmune reactions, heaviness of inflammatory diseases and the occurrence of secondary complications).A traditional and effective method of treatment pseudotumor orbit - local or systemic steroid therapy, including the use of retro-bulbar injection of diprospan or celestone 0.5-1.0 ml, eye drops 0.1% dexamethasone (1-2 drops every 2 h in the beginning of treatment and then every 4-6 hours) and tablets of 0.5-1.0 mg of dexasone.The closest in technical essence is a method of treating pseudotumor orbit, consisting in the combination of the combined use of corticosteroids and immunomodulators, where as immunostimulant use decaris oral 150 mg daily for three days, then after a week's break a repeated administration of the drug in the specified schema (Averyanova O. S. Ophthalmological journal, 1991, 2, S. 75-78). As a result of such treatment noted marked increase in T-lymphocytes, the tendency to normalization of the other indicators of immune status of patients.However, it must be used with caution when indicated (especially when proven amansii may not immunostimulating as an immunosuppressive effect, and in some cases small amounts decaris.The technical result of the invention is to improve the effectiveness of treatment and speed up recovery time.The technical result is achieved corticosteroid and immunomodulator therapy, characterized in that in the complex treatment as an immunomodulator used bromantan - N-(2-substituted)-N-paraproteinemic oral 0.05 1 g once a day for 3 days, the total duration of treatment with corticosteroids is 18.43.2 days.Bromantan has a pronounced adaptogenic action, combined with antiradical activity and detoxifying effect. The drug is recommended in diseases associated with the functional disorder of immunity, immunodeficiency States, to enhance the protective functions of the organism (Morozov, I. S. et al., 1993).In experimental models revealed a marked effect of bromantane on the primary immune response. The drug enhances humoral immunity, which is manifested in the increase in the number antitelomerase cells in the spleen. The drug is effective response to the background cytotoxic immunosuppressive drugs (cyclophosphamide) bromantan exceeds prodigiozan and T-activin (Sevec A. N., 1990), especially because cyclophosphamide is often prescribed in addition to hormonal therapy of pseudotumor orbit to enhance the anti-inflammatory action (Averyanova O. S. Ophthalmological journal, 1991, 2, S. 75-78).The purpose of bromantane is determined by the need to accelerate the rehabilitation process of patients with recurrent pseudotumoral orbit and reducing the frequency of relapses, which is associated with improvement in some of the investigated indicators of immunity.Bromantan helps to normalize the level of endogenous glucocorticoids. This distinguishes the product from other Immunostimulants (mielopid, decaris). Because of the high level of hormones of the adrenal cortex, is associated with long-term adaptation and stress, or low, on the background of steroidtherapie, complicates the rehabilitation process and leads to immunosuppressive States.The proposed method of treatment of pseudotumor orbit as follows.Appoint retro-bulbar injection drugs glucocorticoid range of 0.5-1.0 ml (dexason, Celeste, diprospan) and from the first day of treatment bromantan within 3 days once oral tablets of 0.05,
3+CD4+and restoration of immunological parameters occurred 3-4 days after dosing, and persisted for 3-4 months approximately at the same level. So the content of T-lymphocytes (109/l) after administration of bromantane on day 7 was increased from 0,850.11 to 1,40of 0.18 (p<0,01); CD3 - 0,870,07 1,520,19 (p<0,01); CD4 - 0,490.05 to 0,740,10; HLA-DR - 0,520.06 to 0,88of 0.18, respectively. The course of treatment (rehabilitation) was 18.43.2 days and was less control 2.10,6 (p<0,05). Recurrences during the follow up period (6 months) in the group where he was appointed bromantan, is not revealed. In the control registered 2 relapse (p<0,05). Example, the patient M. the History 2657. The diagnosis of ML - pseudotumor orbit. Diagnosis verified. Combined use of corticosteroids and immunocorrector bromantan of the proposed method: retrobulbar ledah 0.05, The course of treatment was 18 days. On the 19th day the patient received the treatment were observed elimination of clinical symptoms of pseudotumor orbit.The data obtained indicate pronounced immunokorrigiruyuschy effect bromantane and rationality of its application in complex treatment of pseudotumor orbit, which leads to long-term stabilization process with elimination of clinical symptoms of the disease. A method of treating pseudotumor orbit, consisting of corticosteroids and immunotherapy, characterized in that as an immunomodulator used bromantan oral 0.05 1 g once a day for 3 days, and the treatment is 18.53.6 day.
< / BR>where R1represents a hydrogen atom, a metal group2-C6is an alkyl group, acetyl group, -CO-C2-6is an alkyl group or-CO-C6-18-aryl group, unsubstituted or substituted-HE or-O-C1-6is an alkyl group; or a counter cation selected from the group comprising cations of alkaline or alkaline earth metals such as Li+, Na+, K+, CA++, Mg++, NR16R17R18R19( + ) where R16, R17, R18and R19independently from each other selected from hydrogen or C1-C6-alkyl; R2and R3form part of the group with a double bond WITH17= C18or tautomer, enantiomer, or stereoisomer, or its physiologically acceptable salt, or MES, or mixtures thereof
< / BR>where R and R are independently selected from the group consisting of hydroxyl and a moiety that can be converted in vivo in hydroxyl, such as acyloxy, -OR4, -OC(O)R7or-OC(O)OR4(where R4represents alkyl, alkenyl, quinil or aryl; and R7represents amino, alkylamino, aminoalkyl and alkylsulfonyl); and R3represents-CH2- or-CH2CH2-; or its pharmaceutically acceptable salt, where the specified compound or salt is optically active because they contain more than 50% (by weight relative to all stereoisomers) 2S stereoisomers