ABSTRACT
Clinical and pathomorphological outcomes of coronary syndrome X in 40 patients with intact subepicardial coronary arteries are analysed based on the results of 15 year-long monitoring. Primary examination revealed microvascular lesions in the coronary vessels in the form of idiopathic microangiopathy and plastic cardiomyocyte insufficiency confirmed by endomyocardial biopsy studies. The commonest undesirable outcomes after 15 years were myocardial infarction (7.5%), cerebral stroke (10%), persistent cardiac rhythm disturbance (15.4), and sudden cardiac death (17.5%). Sub-epicardial coronary arteries remained unaltered in 82.5% of the patients although they suffered atherosclerosis of peripheral arteries. It appears that coronary syndrome X is a specific microvascular form of coronary heart disease (MCHD) always coupled to systemic vascular pathology. The main consequence of MCHD is remodeled metabolism and biochemical changes contributing to multifocal systemic atherosclerosis. MCHD is diagnosed 10-15 years earlier than classical CHD. At the late stage of pathomorphogenesis, MCHD may remain a self-contained nosological form comparable with atherosclerotic CHD in terms of severity and clinical manifestations. MCHD is characterized by systemic atherosclerosis of peripheral arteries and (in 1/5 of the patients) by coronary atherosclerosis.
Subject(s)
Coronary Circulation , Microvascular Angina/diagnosis , Myocardium/pathology , Adenosine/administration & dosage , Adult , Biopsy , Death, Sudden, Cardiac/epidemiology , Diagnosis, Differential , Exercise Test , Follow-Up Studies , Humans , Injections, Intravenous , Male , Microvascular Angina/mortality , Microvascular Angina/physiopathology , Middle Aged , Retrospective Studies , Siberia/epidemiology , Survival Rate/trends , Time Factors , Tomography, Emission-Computed, Single-Photon , Tomography, Spiral Computed , Vasodilator Agents/administration & dosageABSTRACT
AIM: To examine clinical efficacy of combined therapy with reaferon and iodantipirin in patients with chronic hepatitis B and C of moderate activity. MATERIAL AND METHODS: 100 patients with confirmed diagnosis of chronic viral hepatitis (CVH) at the stage of replication. All the patients have undergone puncture biopsy of the liver with estimation of index of histological activity Knodell and index of fibrosis Desmeth. RESULTS: Comparative evaluation was made of clinical efficacy of combined therapy reaferon + iodantipirin and monotherapy with reaferon in 100 patients with moderate activity CHB and C. CONCLUSION: Conventional scheme with reaferon turned out less effective than the above combination therapy.
Subject(s)
Adjuvants, Immunologic/therapeutic use , Hepatitis B, Chronic/drug therapy , Hepatitis C, Chronic/drug therapy , Interferon Type I/therapeutic use , Iodine Compounds/therapeutic use , Pyrazolones/therapeutic use , Adult , Biopsy, Needle , Drug Therapy, Combination , Female , Hepatitis B, Chronic/pathology , Hepatitis C, Chronic/pathology , Humans , Interferon alpha-2 , Interferon-alpha , Liver/pathology , Male , Recombinant Proteins , Severity of Illness IndexABSTRACT
A hundred and one patients with chronic viral hepatitis (CVH) in the phase of replication were examined. Group 1 comprised 53 patients with CVH in combination with chronic opisthorchiasis. Group 2 (a comparison group) included 48 patients with CVH without opisthorchiasis. According to the etiology of hepatitis, each group was divided into 3 subgroups: subgroups 1a and 2a consisted of patients with CVHB; 1b and 2b included those with CVHC, and 1c and 2c comprised those with CVHB+C. The clinical, functional, and morphological status of the liver was studied and hepatic tissue was qualitatively and quantitatively assessed in all the examinees. The findings suggest that Opisthorchis is an additional factor that aggravates hepatic damage in patients with CVH in the replicative phase of infection.
Subject(s)
Hepatitis B, Chronic/complications , Hepatitis C, Chronic/complications , Opisthorchiasis/complications , Biopsy, Needle , Chronic Disease , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/pathology , Hepatitis B, Chronic/virology , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/pathology , Hepatitis C, Chronic/virology , Humans , Liver/pathology , Opisthorchiasis/diagnosis , Time Factors , Virus ReplicationABSTRACT
The treatment was given to 100 patients with chronic virus hepatitis of moderate activity and chronicity stage I. Of them, 50 patients received reaferon (3 IU 3 times a week) in combination with antiviral and immunomodulating drug iodantipirin (100 mg/d) given on the days of reaferon injections for 6 months. The other 50 patients received reaferon alone in the same doses and duration of the treatment course. Efficiency was assessed by the level of ALT, findings at polymerase chain reaction, index of histological activity of hepatic biopsy. The combined scheme demonstrated higher efficiency and tolerance.
