Method for treating atherosclerosis

FIELD: medicine, cardiology.

SUBSTANCE: the suggested method should be performed at the background of medicinal therapy with preparations out of statins group, tevetene, polyoxidonium and conducting seances of plasmapheresis by removing 800 ml plasma twice weekly with N 5 due to additional intramuscular injection of immunophan 0.005%-1.0 with N 10 and fluimucyl 300 mg intravenously daily with N 5-10, total course of therapy lasts for 2 mo. The method provides modulation of leukocytic functional activity, moreover, due to altered cytokine profile and, thus, through disintegration of protein-lipid complexes participating in the development of atherosclerotic platelets.

EFFECT: higher efficiency of therapy.

3 ex

 

The invention relates to medicine, namely cardiology and treatment of vascular diseases, and can be used for volume reduction or complete elimination of atherosclerotic vascular lesions (plaques) in patients with atherosclerosis at various locations.

A known method of treatment of atherosclerosis by correcting risk factors for development and progression of the disease. Drug therapy is used to reduce the concentration of cholesterol in the blood. The most promising drugs in this direction are statins (inhibitors of HMG-COA reductase). The main clinical effect of statins is their ability to slow down the atherosclerotic process. There is evidence that long, for 3 years, therapy with lovastatin decreases the maximum thickness of the intima-media of the carotid arteries in the area of atherosclerotic lesions in average only 0,009 mm per year (Karpov R.S., Dudko VA Atherosclerosis: pathogenesis, clinic, diagnostics, treatment. - Tomsk: STT, 1998. - S-522).

Disadvantages: it is proved that atherosclerosis is usually a progressive disease. Data about the possibility of a significant reduction in the size of atherosclerotic plaques using drug therapy have not been received.

The invention is directed to solving the problem of increasing the efficiency with the person in treatment of atherosclerosis.

The solution of the stated problem is achieved by medical treatment of a patient who has any clinical manifestations of atherosclerotic process and the presence of atherosclerotic plaques by ultrasound scanning or radiopaque method.

The method consists in drug modulation of the functional activity of leukocytes, blood pressure, modulation of cytokine profile and other mechanisms of the inflammatory response, as well as the disintegration of the protein-lipid complex. With this purpose, patients were prescribed the following medications: Teveten 600 mg per day orally, Imunofan of 0.005% to 1.0 intramuscularly No. 10 in a day, polyoxidonium 6 mg intramuscularly No. 5-10 a day, fluimucil 300 mg intravenously No. 5-10 daily, the drug from a group of statins (atorvastatin 10 mg / day or simvastatin 20 mg / day, or other appropriate doses), the course of 1-2 months, was used plasmapheresis to remove 800 ml plasma 2 times a week 5. The total course of treatment was 2 months.

The method is as follows.

Patient with atherosclerosis, which method of ultrasonic scanning of the main vessels in established atherosclerotic process with stable disease, prescribe: Teveten 600 mg per day orally, Imunofan ,005% - 1,0 intramuscularly No. 10 in a day, polyoxidonium 6 mg intramuscularly No. 5-10 a day, fluimucil 300 mg intravenously No. 5-10 daily, the drug from a group of statins (atorvastatin 10 mg / day or simvastatin 20 mg / day, or other appropriate doses), the course of 1-2 months, sessions of plasmapheresis to remove 800 ml plasma 2 times a week 5. The total course of treatment is 2 months. Treatment is considered successful if during the control study (for example, ultrasound scan of arterial vessels) the volume of atherosclerotic lesions is reduced by 30-50% from the original and more. In case of insufficient effect, it is advisable to re-treatment.

Examples of specific performance.

Example 1. Sick Hours, 54 years old. Diagnosis: Hypertension stage II, grade 2 increase AD risk 3. Atherosclerosis of both common carotid and right femoral arteries. N. 0. Concomitant disease: asthma lung persistent currents. Day 0.

When examining 30.05.03 by ultrasonic scanning of the main vessels on the machine Hewlett Packard Sonos 4500 identified 3 atherosclerotic plaque: in the right carotid artery, the bifurcation region (1,20×0,170 cm in the longitudinal projection), the left common carotid artery (1,48×0,161 cm in the longitudinal projection) and the right femoral artery in the area of the bifurcation (2,34&x000D7; 0,245×0,201 cm in the longitudinal projection), which is dened since 2001 and is stable, electron dense plaque.

After treatment, including the use of Teveten ® (600 mg 1 time per day), imunofana (of 0.005% to 1.0 intramuscularly No. 10 a day), polyoxidonium (6 mg intramuscularly No. 10 a day), fluimucil 300 mg intravenously No. 5, vasilia 20 mg per day for 2 months, plasmapheresis No. 5 with the removal of 800 ml of plasma and intervals of 2-3 days between treatments, 05.08.03 revealed a significant decrease in atherosclerotic plaques of both carotid arteries, where it was determined the residual changes in the form of thickening of the intima without narrowing the lumen of the vessels: in the right carotid, in the area of the bifurcation (0,884×is 0.135 cm in the longitudinal projection), the left common carotid artery (0,648×0,132 cm in the longitudinal projection). In the right femoral artery, in the area of the bifurcation significant changes in the size of the plaques has not occurred (2,67×0,172×0,275 cm in the longitudinal projection). The overall effectiveness of the treatment according to the results of ultrasound scanning of the main vessels amounted to about 17%.

Example 2. Patient P., aged 57. Diagnosis: Hypertension stage II, 3 degree increase AD risk 3. Obliterating atherosclerosis of both common carotid arteries with stenosis of both vessels up to 50%. N. I.

When examining 22.05.03 by ultrasonic scanning of the main vessels in Apparate Hewlett Packard Sonos 4500 revealed atherosclerotic lesion with a 44% (right) and 55% (left) stenosis of the internal carotid arteries: the left internal carotid artery, in the area of the bifurcation (thickness 0,193 cm)in the left common carotid artery (0,403×0,604 cm in the transverse projection)in the right internal carotid artery, in the area of the bifurcation (0,369×0,875 cm in the transverse projection) and the right common carotid artery (1,23×0,201 cm in the longitudinal projection).

After treatment, including the use of Teveten ® (600 mg 1 time per day), imunofana (of 0.005% to 1.0 intramuscularly No. 10 a day), polyoxidonium (6 mg intramuscularly No. 10 a day), fluimucil (300 mg intravenously No. 5), Liprimar 10 mg per day for 1 month, plasmapheresis No. 5 with the removal of 800 ml of plasma and intervals of 2-3 days between treatments, 04.08.03 identified: 4 area of atherosclerotic lesions of carotid arteries with the highest level of stenosis to 45% (left) and a noticeable reduction of atherosclerotic lesion of the right common carotid artery with stenosis of 30%. I.e. the decrease in the degree of stenosis was 14% right and 10% to the left of the size of the vessel lumen. In the left internal carotid artery, in the area of the bifurcation (thickness 0,207 cm - without speakers), the left common carotid artery (0,403×0,763 cm - without dynamics)in the right internal carotid artery, in the area of the bifurcation (0,193×0,745 cm - significantly (55%) smaller than the original size), the right common carotid artery (1,21×0,191 cm in the longitudinal projection).

A second course of treatment, including the use of Teveten ® (600 mg 1 time per day), monatana (0,005% - 1,0 intramuscularly No. 10 a day), polyoxidonium (6 mg intramuscularly No. 10 a day), fluimucil (300 mg intravenously No. 5), Liprimar 10 mg per day, the course of 1 month, plasmapheresis No. 5 with the removal of 800 ml of plasma and intervals of 2-3 days between treatments. Results: in the left internal carotid artery, in the area of the bifurcation (thickness 0,202 cm - without speakers), the left common carotid artery (strength of 0.159×0,717 cm - decrease by more than 50%)in the right internal carotid artery, in the area of the bifurcation (0,190×0,483 cm - significantly, by almost 72%, smaller than the original size), the right common carotid artery (0,833×0,176 cm in the longitudinal projection - reduction of 37%).

Example 3. The described method of treatment used in 5 patients with various cardiovascular diseases (ischemic heart disease, hypertensive disease, ischemic brain disease, atherosclerosis femoral arteries). By ultrasound scanning of the main vessels of atherosclerotic lesion identified in all patients from 3 to 14 of atherosclerotic plaques. Significant (20-50 % and more of the original size reduction of individual atherosclerotic plaques was observed in all patients received treatment according to the above-described treatment program. All five patients separate areas of atherosclerotic lesions of the arteries had no dynamics in the treatment process. On average, when anaemia technique made it possible to achieve about 30% regression of the volume of atherosclerotic lesions.

The control group consisted of 5 patients with ischemic heart disease and hypertensive disease, comparable with the main group observations on the clinical manifestations of the disease, age and gender composition of the group, in which when performing ultrasound scanning of the main vessels were installed signs of atherosclerotic lesions of varying severity, but without significant stenosis of blood vessels (no more than 10-15% of the diameter of the lumen of blood vessels). This group of patients received treatment with inhibitors of angiotensin-converting enzyme in combination with or without diuretics, and simvastatin at a dose of 20 mg per day for 1 year. During the control study of major vessels by ultrasonic scanning characteristics reduce the amount of atherosclerotic lesions is not installed.

In both groups, the clinical effect of treatment was expressed as a decrease in blood pressure, reduce the frequency and severity of angina attacks, increase of tolerance to physical activity.

The proposed method allows to reduce the volume and the almost complete elimination of atherosclerotic lesions in patients with atherosclerosis in different locations, leading to increased tolerance to physical activity, to reduce the frequency and intense is vnesti angina in patients with ischemic heart disease, reducing blood pressure in hypertensive patients.

A method of treating atherosclerosis by using drug therapy with statins, of Teveten®, polyoxidonium and sessions of plasmapheresis to remove 800 ml plasma 2 times a week 5, wherein the patient is additionally given Imunofan of 0.005% to 1.0 intramuscularly every other day No. 10 and fluimucil 300 mg intravenously daily No. 5-10, the total course of treatment for 2 months.



 

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