Method for correction of platelet membrane lipid composition and activity at metabolic syndrome

FIELD: medicine, cardiology, endocrinology.

SUBSTANCE: method involves administration of simvastatin in patients in the dose 5 mg, once before night, and nebivolol in the dose 5 mg, once in the same time on the background of individually selected hypocaloric diet. Treatment is carried out for 24 weeks, not less. Method provides optimization of intravascular activity of platelets due to normalization of lipid composition of their membranes and enhancing level of antioxidant protection. Invention can be used in correction of lipid activity of platelet membranes and activity at metabolic syndrome.

EFFECT: improved correction method.

2 ex

 

The invention relates to medicine, namely to Hematology, cardiology and endocrinology.

Analogues of the proposed method of correction of the lipid composition of membranes and platelet activity in patients with metabolic syndrome (MS) does not exist.

In the literature there are recommendations for a low-calorie diet for the correction of metabolism in the metabolic syndrome (Diamond, VA, Supportive AV, Shlyakhto E.V., Krasilnikova H. Metabolic cardiovascular syndrome. SPb.: Ed. SPb. (MCM). 1999. - 208 S.) and the decrease in the degree of abdominal obesity, which is the component with the recommendations focused on the use of a low-calorie diet (Savelyeva L. Modern approaches to treatment of obesity. // The doctor, 2000, No. 12 - p.12-14; Kadyrov, BC, Salhanov B.A. Nutrition in obesity. Alma-ATA ″Kazakhstan″, 1990).

Patients with different MS clusters can be assigned the preparation of simvastatin order correction of dyslipidemia (David Glairon, Sergio Fazio, Mac RAE, Flinton. Modern prospects for the use of statins. // International Medical journal. - 2000. No. 6. - S-522).

For correction of blood pressure in metabolic syndrome are selective β-blockers, one of which is nebivolol.

However, never before medical complex, consisting of individually under the early low-calorie diet and drugs - nebivolol and simvastatin, were not used in hypertensive patients with metabolic syndrome to normalize the gradient cholesterol/phospholipids in the membranes of blood platelets and reduce the activity of platelet aggregation (adhesion function of blood platelets, platelet aggregation with ADP, collagen, thrombin, ristomycin, hydrogen peroxide, epinephrine -, and combinations of inductors - ADP+epinephrine, ADP+collagen, adrenaline+collagen, as well as optimization of intravascular platelet activity, level of lipid peroxidation and antioxidant protection of blood platelets).

The aim of the invention is to increase the efficiency of correction of disorders of platelet aggregation in patients with metabolic syndrome.

The essence of the proposed method lies in the fact that for the correction of the lipid composition of the membranes and the activity of platelet aggregation in patients with metabolic syndrome permanently assigned individually selected low-calorie diet and drugs simvastatin 5 mg 1 time per day in the evening and the nebivolol dose of 5 mg of 1 times a day.

The method allows to adjust the lipid composition of the membranes of platelets and activity of primary hemostasis in patients with MS within six months, bringing it to a level close to that of healthy people. Subject to sleduushem recommendations of the proposed method it is possible the maintenance of the lipid composition of the membranes of platelets and their activity in an optimal state, that will allow persons with MS significantly reduce the risk of thrombotic complications, reduce the number of cases of temporary disability, to accelerate and to improve quality of care, reduce disability, and also to prolong the life and reduce mortality of patients with MS from a heart attack and stroke.

The inventive method is carried out as follows.

To create a negative energy balance in the body, patients are advised individually selected low-calorie diet.

Calorie intake is calculated in kcal individually for each patient with MS according to the formula:

for women 18-30 years (0,0621 × body mass, kg + 2,0357)×240,

31 - 60 years (0,0342 × body mass, kg + 3,5377)×240,

over 60 years of age (0,0377 × body mass, kg + 2,7545)×240,

for men 18-30 years (0,0630 × body mass, kg + 2,8957)×240,

31 - 60 years (0,0484 × body mass, kg + 3,6534)×240,

over 60 years of age (0,0491 × body mass, kg + 2,4587)×240.

The resulting value remains unchanged with minimal physical activity, multiplied by a factor of 1.3 at a moderate and 1.5 at high physical activity (usually in patients with MS, the level of physical activity low).

It is recommended that 3 main meals and 2 intermediate. It is recommended that the following distribution of daily calories: Breakfast - 25%, 2nd Breakfast - 10, lunch - 35%, tea - 10%, dinner - 20%.

To compile menu the patient uses a special table with the instructions of the chemical composition and caloric content of products, given that the main sources of energy: protein (1 g contains 4 kcal), fat (9 kcal), carbohydrates (4 kcal) and alcohol (7 kcal).

The second component of the proposed method - the purpose of simvastatin 5 mg 1 time a day at night, the third component nebivolol 1 time at the same time.

Example 1.

Patient S., 64 years old, with body weight to 98.4 kg, body mass index to 32.7 kg/m2(Protocol No. 072), suffering from metabolic syndrome for 16 years, when the survey was identified thrombocytopathies with increasing aggregation and intravascular platelet activity on the background of impaired glucose tolerance and hyperlipidemia II b type with mild hypercholesterolemia. The patient was assigned individually selected low-calorie diet (1551,4 kcal), simvastatin 5 mg at night and nebivolol 5 mg 1 time per day. The patient looked through 4,12 and 24 weeks after starting treatment. Simultaneously with the inspection was carried out biochemical and hematological analysis of blood.

To week 24 of treatment, the patient had normal body weight (75,4 kg) and body mass index (25,1 kg/m2), was achieved full normalization of blood lipid spectrum, test glucose tolerance, perekisnogo the oxidation of plasma lipids and antioxidant capacity of the liquid portion of blood, platelet aggregation with ADP, collagen, thrombin, ristomycin, hydrogen peroxide, epinephrine -, and combinations of inductors - ADP+epinephrine, ADP+collagen, adrenaline+collagen, as well as optimization of intravascular platelet activity, level of lipid peroxidation and antioxidant protection of blood platelets with the normalization of the gradient cholesterol/phospholipids in their membranes.

The patient is asked to comply with these recommendations in future.

Example 2.

Patient G., 39 years old, with body weight 96,0 kg, BMI of 35.2 kg/m2(Protocol No. 077), suffering from metabolic syndrome for 6 years, when the survey was identified thrombocytopathies with increasing aggregation and intravascular platelet activity on the background of impaired glucose tolerance and hyperlipidemia II b type with mild hypercholesterolemia. The patient was assigned individually selected low-calorie diet (2128,1 kcal), simvastatin 5 mg at night and nebivolol 5 mg 1 time per day. The patient looked through 4,12 and 24 weeks after starting treatment. Simultaneously with the inspection was carried out biochemical and hematological analysis of blood.

To week 24 of treatment, the patient had normal body weight (75,2 kg) and body mass index (27,6 kg/m2), was achieved full normalization of blood lipid spectrum, test tol is rennosti to glucose, peroxidation of plasma lipids and antioxidant capacity of the liquid portion of blood platelet aggregation with ADP, collagen, thrombin, ristomycin, hydrogen peroxide, epinephrine -, and combinations of inductors - ADP+epinephrine, ADP+collagen, adrenaline+collagen, as well as optimization of intravascular platelet activity, level of lipid peroxidation and antioxidant protection of blood platelets with the normalization of the gradient cholesterol/phospholipids in their membranes.

The patient is recommended to follow the instructions given in the following.

The use of the proposed method of correction of platelet disorders in Hematology, cardiology and endocrinology will help to avoid many of vascular complications in patients with metabolic syndrome, to reduce their number of cases of temporary disability, to reduce the duration of hospitalization, reduce morbidity and mortality.

The correction method of the lipid composition of membranes of blood platelets and activity of platelet aggregation in patients with metabolic syndrome, including the use of individualized low-calorie diet, simvastatin 5 mg 1 time at night and nebivolol 5 mg 1 time at the same time.



 

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