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  2. .. // , ., ., . — 2002, 3. — . 15-17.
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  4. Rugge M., Leandro G., Levin K.J. et al. Gastric epithelial dysplasia // Cancer. — 1995, vol.76. — p. 376-382.

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Источник

.., .., .., .., .. : // . — 2020. — . 92. — 8. — C. 18-23.

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: .., .., .., . : // . — 2020. — . 92. — 8. — C. 18-23. doi: 10.26442/00403660.2020.08.000693

Chronic gastrite: modern e of the problem

O.N. Minushkin1, I.V. Zverkov1, N.V. Lvova2, Yu.S. Skibina1, V.S. Inevatova3

1 Central e Medical Academy of Department of Presidential Affairs, Moscow, Russia;

2 Moscow Re and Practical Centre for of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia;

3 ICC Chekhov Branch, Chekhov, Russia

Aim. To evaluate the modern view on the problem of chronic gastritis and the effectiveness of the drug ursodexic acid (UHC) Grinterol in the treatment of patients with chronic antral reflux-gastritis (biliar).

Materials and methods. The work provides modern ideas chronic gastritis, the issues of etiology and pathogenesis are considered. Contemporary classifications and the attitude of the s of the work to them are presented. Clinical studies were conducted in 50 patients with chronic antral reflux-gastritis biliary (32 women and 18 men) between the ages of 20 and 80 years (average age 50.3 to 8.0 years). The treatment uses the drug Grinterol in a daily dose of 12.5 mg/kg of body weight for 4 weeks.

Results. Among patients with chronic antral gastritis isolated patients with reflux-gastritis biliary, the pathogenetic factor of which is the damaging property of aggressive bile acids. The main treatment for such patients are drugs UHC (in this study (this study uses Grinterol at a daily dose of 12.5 mg/kg of body weight); the duration of treatment is 4 years. The overall efficiency (according to endomorphological data) was 76%, according to clinical data 100%.

ion. Critical consideration of the classifications used and proposed for consideration indicates that the has come for the adoption of a new classification with the allocation of reflux-gastritis biliary. Treatment of this form of antral gastritis is effective with UDHC drugs.

Conclusion. The selection of a form of antral reflux-gastritis biliar in a separate classification group is scientifically justified. The results suggest that for the treatment of patients with chronic biliary refluxdrugs of choice are drugs UDHC.

Keywords: chronic gastritis, chronic antral reflux gastritis (biliary), Grinterol.

For citation: Minushkin O.N., Zverkov I.V., Lvova N.V., et al. Chronic gastrite: modern e of the problem. Therapeutic . 2020; 92 (8): 1823. DOI: 10.26442/00403660.2020.08.000693

H.p. Helicobacter pylori

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  11. .., .., .., .. Helicobacter pylori: . . 2014;86(3):94-9 [Maev IV, Kucheryavyi YuA, Andreev DN, Barkalova EV. Eradication therapy for Helicobacter pylori infection: review of world trends. Therapeutic . 2014;86(3):94-9 (In Russ.)].
  12. .., .. — . . 2017;89(8):5-12. doi: 10.17116/terarkh20178985-12 [Maev IV, Andreev DN. Molecular genetic predictors of resistance to anti-Helicobacter pylori therapy. Therapeutic . 2017;89(8):5-12 (In Russ.)]. doi: 10.17116/terarkh20178985-12
  13. .., .., .. Helicobacter pylori . . 2017;89(2):84-90 [Andreev DN, Dicheva DT, Maev IV. Possibilities for optimization of eradication therapy for Helicobacter pylori infection in modern clinical practice. Therapeutic . 2017;89(2):84-90 (In Russ.)]. doi: 10.17116/terarkh201789284-90
  14. .., .., .. л . . 2008;4:1-4 [Loranskaya ID, Rakitskaya LG, Mamedova LD. The use of the drug Pepsan R in the treatment of gastroesophageal reflux disease. Experimental and clinical gastroenterology. 2008;4:1-4 (In Russ.)].
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  16. . . . 2-. 2016 [Ursode oxycholic acid preparations in clinical practice. Toolkit. Ed. 2nd. 2016 (In Russ.)].

.

:

…, ., . . . , ; : oleg.minushkin@ bk.ru; RCID: 0000-0002-7723-7992

…, . . . ORCID: 0000-0001-6210-8955

…, . . . . ORCID: 0000-0002-0840-4590

…, — . . ORCID: 0000-0002-3946-4983

. . . ORCID: 0000-0002-9678-342

«»

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Источник

.., .., .., .., .., .. // . 2009. 1. . . 612.

.. , .. , .. , .. , .. , ..

— , 2,

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1

61

61,11 17,82

107,42 + 12,95***

73,13 10,25*

2

96

35,21 8,42***

54,05 11,22***

64,47 15,87

51

51,59 11,89

96,24 14,26

62,14 14,31

28

40,90 7,03***

51,12 13,93***

67,68 16,73

17

13,16 6,35***

14,80 5,43***

68,60 16,59

3

49

70,49 10,75**

139,45 10,01***

37,81 16,77***

18

68,50 10,99*

141,65 10,21***

57,19 13,42*

17

70,43 8,64*

116,55 13,60***

41,84 6,80***

14

72,56 12,64**

105,71 6,22**

14,41 5,10***

4

45

33,56 + 8,7*** ,

51,47 8,4***

38,29 7,90***

14

54,99 + 6,72

96,47 8,32

59,45 12,60*

16

33,96 16,00**

44,65 12,62***

39,70 8,59***

15

11,74 3,40***

13,31 4,34***

15,73 2,52***

5

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56,44 20,24

93,57 13,59

67,29 13,04

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HP- . : IgG ( 95% ); IgG +, +, ( 70% ) — G-, ; IgG ( 50% ) 12- , ; I; , , 5% . ( , — ; ) (4).

, HP 50-70% (3, 13). , , , I, I, , , , , . . , , .

293 ( 56,1 + 13,4 ), :

  1. ( = 61);
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— -. (1996) (18), () — (2000) (19).

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2.

HP

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N

%

N

%

N

%

%

(),

n — 251

33

13,14

109

43,43

102

40,64

7

2,79

+ (n = 174)

26

14,94

87

50,00

57

32,76

4

2,30

-(n = 77)

7

9,09

21

27,27

45

58,44

3

3,90

. (), n = 61

23

37,70

34

55,74

4

6,56

0,00

HP + (n =48)

19

39,58

26

54,17

3

6,25

0,00

-(n = 13)

4

30,77

8

61,54

1

7,69

0,00

. (), n = 190

10

5,26

75

39,47

98

51,58

7

3,68

+ (n = 12)

7

5,55

61

48,41

54

42,86

4

3,17

-(n = 64)

3

4,68

14

21,87

44

68,75

3

4,69

HP- 10 . . , ( = 68) () (, , 2 ), ( = 58) — (- 240 2 ). II (2000).

4-6 . , HP . — — ( 2 , ), (- 240 2 ) — . — , ( , , , HP, , HP) .

, HP- 78,69%, 66,66%, 67,31%, 64,67%, , (5,9, 10, 12, 13, 14). HP- .

HP ( 50 ) : 40,98%, 20,89%, 22,45%, 15,56%, . HP , , : , HP, IgA, , .

, , , , HP-, ( ), , , .

: 22,95%, 61,45%, 65,31%, 69,0%, ; , 13,11%, 29,16%, 26,53%, 40,0%, .. , . , : .

HP , , .

, , ( , ) 4,89%, 7,29%, 8,16%, 15,55%, .

, . , : (3 ) — 3,26%, 4,16%, 4,08%, 6,66%, (4.1 ) — 0,0%, 1,04%, 0,0%, 6,66%. (14, 16, 17, 20). , — .

1, , (G-17) (stG-17) ( G-), (56,44 + 20,24/ 93,57 13,59) (40,90 + 7,03/51,12 13,93, < 0,001) (13,16 + 6,35/14,80 5,43, < 0,001).

, ( ) PG-I. (67,29 13,04) ( 57,19 + 13,42, 41,84 6,80, 14,41 + 5,10) ( < 0,05-0,001).

() ( < 0,05-0,001).

G-17 (107,42 + 12,95, < 0,001) PGI (73,13 10,25, < 0,05).

251 . 2.

13,14% (n = 33) , (2 = 92,58, < 0,001, d.f. = 1) 37,70% (n = 23). — , ( > 0,05) — 14,94% (n = 26): 39,58% (n = 19) 5,55% (n = 7), , HP- — 9,09% (n = 7): 30,77% (n = 4) 4,68%, (n = 3), . , , 13,7 + 6,2 : HP 11,2 + 4,6 , HP -16,3 + 7,8 (t = 0,59, > 0,05).

43,43% (n = 109): 55,74% (n = 34) 39,47% (n = 61), ( ), (2 = 4,97, < 0,05, d.f. = 1).

HP 21 ill % (n = 21): 61,54% (n = 8) 21,87% (n = 14), , , .. (2 = 0,34, > 0,05, d.f. = 1). HP- 50,00% (n = 57): 54,17% (n = 26) 48,41% (n = 61), ( > 0,05).

40,64% (n = 102): 6,56% (n = 4) 51,58% (n = 98), ( ).

(2 = 14,60, < 0,001, d.f. = 1) — 58,44% (n = 45) HP — 32,76% (n = 57): 7,69% (n = 1) 6,25% (n = 3), () (2 = 0,03, > 0,05, d.f. = 1), 68,75% (n = 44) 42,86% (n = 54), (2 = 11,39, < 0,001), .. .

2,79% (n = 7) 3,68% (n = 7). ( > 0,05) — 4,69% (n = 3) HP — 3,17% (n = 4). , . () , , — .

, (17,2 5,1 ) (- ). (12,0 + 5,7 ). — — (. = 0,67, > 0,05, d.f. = 5).

92,65% (n = 63) (-) 91,38% (n = 53) — . ( = 10) ( = 3), ( = 7).

(-) — .

(-) HP- , .

HP HP — .

, , , / HP, , (). , — , . HP- HP .

G-17 PG-I . 17 , I — . -17 -I .

  1. , .
  2. — — ; — (-). , .
  3. 92,65% 91,38% — .
  4. : . pylori , — (-).
  1. .., .., .. . ., 1998. . 13-268.
  2. .., .., .. . Helkobacter pylori I/ . , . ., 2000; 1: 63-65.
  3. .. Helicobacter pylori — : .. …. ., 2007. 380 .
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  5. .. : // . 2003; 19, 3; 30-35.
  6. .., .. -.., 2003:8-263.
  7. .8., .., . : — -? // X . ., 2003. . 223.
  8. .., .., .. . — . . .-., 2004. . 27-29.
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  10. .. // . 2006; XVI, 5:2-7.
  11. .., .., .. . Helicobacter pylori // . 2001; XI, 2: 34-37.
  12. .., .. // . 2003; 5:24-31.
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