Цель. Изучение роли факторов риска в механизмах желчного камнеобразования в зависимости от пола и возраста пациентов.Материал и методы. Обследованы 210 пациентов с I стадией желчнокаменной болезни (ЖКБ). В верификации диагноза использованы ре-зультаты ультразвукового исследования гепатобилиарной системы, многофракционного дуоденального зондирования с последующим ма-кроскопическим, микроскопическим, химическим и физическим исследованием желчи. В порциях «В» и «С» желчи определялась суммарная концентрация желчных кислот, холестерина, с последующим вычислением холатохолестеринового коэффициента. Проведено определение поверхностного натяжения желчи и вязкости желчи. В крови изучено содержание общего холестерина, липопротеидов очень низкой плотно-сти, липопротеидов низкой плотности, липопротеидов высокой плотности, триглицеридов, определялся коэффициент атерогенности. В оцен-ке степени накопления жировой массы тела использовался индекс Кетле. Изучен относительный риск анамнестических факторов риска ЖКБ. Заключение. Полученные данные могут быть использованы в организации диспансерной работы с больными гепатобилиарной патоло-гией и в оптимизации первичной профилактики желчного камнеобразования. Ключевые слова: факторы риска желчного камнеобразования, литогенная желчь, возрастно-половые особенности холецистолитиаза AbstractGoal. Study of the role of risk factors in mechanized gall stone formation depending on sex and age of patients. Material and methodsWe examined 210 patients with stage I gallstone disease (GSD). In verification of diagnosis used an ultrasound study of the hepatobiliary system, multi-grade duodenal sounding with subsequent macroscopic, microscopic, chemical and physical examination of bile. In the portions "b" and "C" bile was determined the total concentration of bile acids, cholesterol, with the subsequent calculation it consists of cholesterol ratio. Estimation of surface tension of bile viscosity and bile. In the studied blood levels of total cholesterol, lipoproteins of very low density, lowdensity lipoproteins, high density lipoproteins, triglycerides, were determined the coefficient of atherogenicity. To assess the degree of accumulation of body fat was used the Quetelet index. Studied the relative risk of anamnestic risk factors of GSD.Results. The features of biliary lithogenesis based on gender and age of patients. High value PR for the gall stone formation are female gender -3,16, Mature and elderly age (older than 50) of 3.67. In young women, gall-stone formation is mainly due to the increase of cholesterol level of bile, at the age of 50 years with a decline in zhelchnokamennaja pool, increased viscosity and surface tension of bile.The most important risk factors of cholecystolithiasis are also gender differences: if women is multiple pregnancies and (or) childbirth (more than 3) -OR 4,62, overweight (BMI over 26) -OR is 4.57 and the violation of the principles of good nutrition (eating disorders, overeating or starvation, the use of large quantities of animal fats) -OR 3,94, for men it's...
Chemical content of leaves and fruits of the low growing apple trees on the rootstocks SК4 and М9 in the result of application of foliar feeding with water solutions of various mineral fertilizers was studied. Special ballastless multi-nutrient fertilizers in solid and liquid forms containing a wide range of chelated microelements were used. The effect of foliar feeding on the content in plants and fruits of macro-and microelements at the fruit maturity stage was estimated with the help of the method of leaf analysis. Significant stable increase of the content of nitrogen and potassium was observed in the leaves of apple trees on the rootstocks SК4 and М9. The content of potassium and calcium in apples became higher. With the help of statistical analysis it is shown that there exists close correlation between the content of elements in leaves and fruits: (N) r = 0.79; (K) r = 0.77; (Ca) r = 0.94; (Cu) r = 0.75; (Mn) r = 0.89; (Zn) r = 0.75; (B) r = 0.70. In the result of our physiological and biochemical tests positive effect of mineral feeding on the functional condition of apple trees during summer season when being subjected to intensive hydrothermal stress factors was established. The foliar feeding effect appeared as changing of the ratio of water fractions in the apple tree leaves at the background of increasing atmospheric drought, which in some years in July and August reached the criteria of "hazardous weather". Sufficient level of water content in the cells of apple trees on the rootstocks SК4 and М9 in case of foliar application of fertilizers was ensured as a result of bound water increasing. Statistic analysis of the experimental data showed significant changes in the ratio of bound and free water fractions. In August, in the environment of strong impact of negative abiotic factors, at higher level of water content in the tissues it was found that the content of pigments in leaves was much higher than in the reference version. The functional changes confirm that application of mineral nutrients contributes to activation of the adaptation mechanism. When foliar feeding is used the content of biologically active substances in apples is the highest: content of vitamin C increases by 13.6 -15.2%, vitamin Рby 8.7 -24.6%.
The results of these comprehensive studies can reveal new pathophysiological patterns of lithogenic bile formation and enhance our understanding of the pathogenesis of cholelithiasis.
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