[CLINICAL EFFICACY OF THE RECEPTOR BETA AND ALPHA BLOCKERS - CARVEDILOL AND ORNITHINE-ASPARTATE IN PATIENTS WITH CHD AND CHF COMBINED WITH ALCOHOLIC LIVER DISEASE].

Aim: The aim of the paper is to study the clinical efficacy of carvedilol and ornithine-aspartate in the complex therapy (ACE inhibitors, diuretics, cardiac glycosides, nitrates indication), to assess their impact on quality of life, intracardiac hemodynamics, remodeling of the left (LV) and right ventricular (RV), indicators of the inflammatory enzyme activity in blood serum of patients with coronary heart disease with CHF II-III FC and alcoholic liver disease (ALD). Materials and Methods: 95 patients were studied 45-75 years (mean age - 58,2 ± 1,2) with CHF II-III FC and postinfarction cardiosclerosis, LVEF less than 45%. ALD was diagnosed in 58 patients. In 23 (39%) patients among them had steatosis, 18 (30.5%) - chronic hepatitis (CH), 17 (30.5%) - liver cirrhosis (LC). Patients were divided into 3 groups. Patients in the first group (37 people) with coronary artery disease and heart failure without a UPS received an average dose of carvedilol in - 32,8 ± 4,7 mg / day. Patients in the 2nd group (32 persons) suffering from coronary artery disease, heart failure, and UPS received carvedilol in an average dose of 25,4 ± 1,6- mg / day and L-ornithine-L-aspartate in a dose of 10 g granulate per day for 2 weeks, and then by 5g a day for 4 months. Patients in the third control group (26 people) with CHD and CHF and CHF ABP received basic therapy (without ß-blocker) and ademetionine at a dose of 800 mg / day for 2 weeks, followed by 400 mg / day for 4 months. Results: After 4 months of observation, it was noted that CHF patients with IHD in combination with BPO flows less favorably. In all groups, the clinical status of patients was improved on the background of the therapy, however, the clinical status was more pronounced while using carvedilol and ornithine-aspartate (Group 2): summary measure of quality of life has improved by 38 points, the speed of the test increased with a digital sequence up to 54.4, decreased shortness of breath, edema, ascites, portal hypertension effects, hepatocellular insufficiency and hepatic encephalopathy. In general, was shown the normalization of sleep rhythm, reducing sleepiness, improved memory, attention, reduced asterixis and sweeping hand tremor, asthenia. Conclusions: The use of carvedilol and ornithine-aspartate in the treatment of patients with CHF FC II-III with CHD and BPO improves the clinical condition of patients, quality of life, hemodynamics, reduces the severity of pulmonary hypertension and normalizes serum biochemical parameters.

[New approaches to therapy of Helicobacterpylori infection (by the materials of the Maastricht Consensus-IV, Florence, 2010)].

European recommendations for eradication of Helicobacter pylori are presented. The increase of the resistance to clarithromycin requires the necessity of rational use of quadritherapy as the first line treatment and sequential therapy including drugs active against the pathogen with low resistance. New treatment regiments for patients with allergy to penicillin are recommended.

[Optimization of treatment of patients with chronic cardiac insufficiency of the ischemic genesis and hobnail liver].

Clinical efficacy of combined therapy including the use of rifaximin and L-ornithin-l-aspartate, as well as the dynamics of the biochemical indices, the manifestation levels of portal-systemic-encephalopathy and intestinal microbiocynosis were investigated in patients with chronic cardiac insufficiency of ischemic genesis and hobnail liver. The combined therapy resulted in improvement of the patients clinical state, lower levels of the portal-systemic encephalopathy manifectation by decreasing hyperammonium, normalization of the large intestine microflora, and blood serum biochemical parameters.