ASSESSMENT OF CARDIOVASCULAR DISEASE RISK FACTORS IN PATIENTS WITH CORONARY HEART DISEASE COMBINED WITH NONALCOHOLIC FATTY LIVER DISEASE.

OBJECTIVE: The aim: To study the risk factors of cardiovascular diseases in patients with coronary heart disease with stable angina pectoris II functional class in combi¬nation with NAFLD. PATIENTS AND METHODS: Materials and methods: The study included 245 patients with a diagnosis of CHD, stable angina pectoris II functional class (FC), who were being treated at the Communal Nonprofit Enterprise «Central City Clinical Hospital¼ of Uzhhorod City Council. We singled out 2 groups of patients: group 1 (n=145) - patients with CHD with stable angina pectoris II FC in combination with NAFLD and group 2 (n=100) - patients with CHD with stable angina pectoris II FC. RESULTS: Results: Analysis of the frequency of occurrence of CVD risk factors in patients with CHD showed that among patients of group 1 there are 50% more people with abdominal obesity, excess body and dyslipidemia. The reliability between the groups in the occurrence of hypertension and type 2 diabetes was not revealed. The obtained results confirm the data that the prevalence of NAFLD increases with increasing body weight and a high degree of obesity increases the risk of its development. CONCLUSION: Conclusions: The most frequent risk factors for CVD in patients with coronary artery disease in combination with NAFLD are hypertension, obesity, and dyslipidemia.

RESPIRATORY MICROBIOME AND ITS RELATIONSHIP WITH INFLAMMATORY MARKERS.

OBJECTIVE: The aim: This study aims to investigate and analyze the microbiome of the nasopharyngeal zone in acute respiratory infections (ARI) and their relationship with inflammatory markers. PATIENTS AND METHODS: Materials and methods: Examination of 112 children (10-14 years old) with acute respiratory infections (ARI) of the upper respiratory tract was carried out. The control group consisted of 25 healthy children identical in age and examination parameters. RESULTS: Results: When analyzing the microflora of the nasopharynx of patients, 29,0% of strains were gram-positive bacteria and 71,0% were gram-negative bacteria (Escherichia coli representing 37,0%). Biochemical examination of the biomaterial revealed the presence of sucrase (n=69), maltase (n=87), lactorepoxidase (n-89) and alcohols - sorbitol (hexahydric alcohol, n=102), mannitol (hexahydric alcohol, n=84), xylitol (pentahydric alcohol, n=86). Regarding the markers of inflammatory response, the following dynamics was noted: increase in the level of IgM (3,91 ± 1,79 g/l, p<0,01) by 2,2 times, elevation of Ig G level by 10 times (145, 91 ± 53,04 g/l, p< 0,01), slightly higher than the reference values IgE level. In addition, increased IL-1, IL-4, IL-6, γ-IFN, TNF-α, Neopterin levels were detected. The level of Thyroid stimulating hormone (TSH) was significantly different compared to the control group (0,62 ± 0,57 vs. 1,98 ± 0,30 mIU/ ml, p< 0,01), but within the reference values. CONCLUSION: Conclusions: Predominance of Gram-negative bacteria in the nasopharyngeal microflora of patients along with elevated inflammatory markers and lactop-eroxydase enzyme predominance was detected in the study.

THE EFFECTIVENESS OF COMPLEX THERAPY WITH THE INCLUSION OF THE URSODEOXYCHOLIC ACID IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE IN COMBINATION WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE.

OBJECTIVE: The aim: Was increase the effectiveness of treatment in patients with non-alcoholic fatty liver disease (NAFLD) comorbid with chronic obstructive pulmonary disease (COPD) by using ursodeoxycholic acid (UDCA) in combination with ademethionine. PATIENTS AND METHODS: Materials and methods: Under observation was 98 patients with a diagnosis of NAFLD and COPD group II or their combination. Patients were divided into 3 groups: 1 (n = 36) - COPD + NASH - in addition to standard COPD therapy received UDCA 15 mg / kg / day - 6 months and ademethionine 1000 mg IV once a day for 10 days, followed by oral administration of 500 mg 2 times per day - 20 days, and group 2 (n = 32) - COPD + hepatic steatosis - in addition to standard therapy - UDCA 15 mg / kg / day - 6 months. Group 3 (n = 30) - COPD received standard therapy for COPD. RESULTS: Results: UDCA with ademethionine on the background of standard COPD therapy reduces the clinical manifestations of NAFLD and normalizes liver function. The combination of UDCA with ademethionine not only has a positive effect on the course of NAFLD, but also reduces the intensity of dyspnea, systemic inflammation, improves the external respiration function and reduces anxiety and depression. Patients receiving UDCA + ademethionine for 6 months of follow-up had no exacerbations of COPD. CONCLUSION: Conclusions: UDCA in combination with ademethionine in COPD courses have a positive effect on the course of NAFLD, and also reduces the intensity of dyspnea, improves the external respiratory function and reduces the frequency of COPD hospitalization.