Введение. Диагностика обострения (активной фазы) хронического пиелонефрита в соответствии с концепцией роли иммунной системы в формировании и, в дальнейшем, утяжелении течения воспалительного процесса является актуальной задачей.Цель исследования. Целью и задачами исследования явилось определение степени тяжести обострения хронического пиелонефрита путем исследования изменений уровня провоспалительных и антивоспалительных цитокинов в моче.Материалы и методы. У 64 больных с активной фазой хронического пиелонефрита в возрасте от 25 до 65 лет представлены результаты исследования содержания провоспалительных(iL-1β, iL-6, iL-8, TNFα, iFNγ) и антивоспалительных(iL-2, iL-4, iL-10) цитокинов в моче, взятой из мочеточника, мочевого пузыря и в плазме крови с целью определения степени тяжести обострения хронического пиелонефрита.Результаты. Уровень провоспалительного цитокина iL-8 в моче из мочеточника пораженной почки может служить основным маркером, определяющим степень тяжести активной фазы хронического пиелонефрита.При легкой степени обострения воспалительного процесса содержание iL-8 в моче из мочеточника больше, по сравнению с нормальными значениями, в 4 раза; при средней степени -в 8 раз, а при тяжелом течении обострения хронического пиелонефрита -в 54 раза.Выводы. Определение провоспалительных цитокинов в диагностике степени тяжести течения пиелонефрита имеет большое диагностическое и дифференциально диагностическое значение, что позволит проводить дифференцированную терапию в зависимости от тяжести воспалительного процесса, улучшить результаты лечения. Ключевые слова: хронический пиелонефрит; тяжесть активной фазы хронического пиелонефрита; провоспалительные и антивоспалительные цитокины Для цитирования: Кореньков Д.Г., Павлов А.Л. Цитокины в диагностике тяжести активной фазы хронического пиелонефрита. Вестник урологии. 2017;5(3):14-21.Introduction. cytokines may serve as markers of the inflammatory process during exacerbation (i.w. active phase) and further progression of chronic pyelonephritis. The estimation of cytokine constellation in this field is important problem of clinical nephrology.Purpose of the study. the aim of the study was to evaluate the severity of chronic pyelonephritis during its exacerbation by measurement of cytokines concentration in urinalysis.Materials and methods. In 64 patients with active phase of chronic pyelonephritis at the age of 25 to 65 years, the results of the study of the content of proinflammatory (iL-1β, iL-6, iL-8, TNFα, iFNγ) and anti-inflammatory (iL-2, iL-4, iL-10) cytokines in urine taken from the ureter, bladder and blood plasma to determine the severity of exacerbation of chronic pyelonephritis.Results. The level of proinflammatory cytokine iL-8 in urine from the ureter of the affected kidney can serve as the main marker determining the severity of the active phase of chronic pyelonephritis. With a mild degree of exacerbation of the inflammatory process, the content of iL-8 in urine from the ureter is 4 times higher than normal values; at an average degree -in 8 times,...
The aim of the study was to evaluate the effectiveness of Tadalafil-SZ in treatment of erectile dysfunction in men suffering from type 2 diabetes mellitus or prediabetes. Two patient groups of thirty people with type 2 diabetes mellitus and prediabetes were identified. Patients mean age was 52.2 3.4 years and 48.5 2.8 years in groups with type 2 diabetes mellitus and prediabetes respectively. All patients suffered from erectile dysfunction, which significantly reduced their quality of life. To assess the erectile function, the ICEF (International Index of Erectile Function) and QoL (Quality of Life) questionnaires were used. Patients with prediabetes took Tadalafil-SZ 5 mg once a day for 3 months and patients with type 2 diabetes mellitus took Tadalafil-SZ 20 mg 2 times a week (Monday and Thursday) for 3 months as a treatment for erectile dysfunction. Results of this study showed that the administration of Tadalafil-SZ not only led to a significant improvement in the quality of life, a significant reduction in weight, body mass index, waist size in patients of both groups, but also led to a glycated hemoglobin level normalization without increasing the dose of glucose-lowering therapy in patients with uncomplicated type 2 diabetes mellitus and a pronounced decrease in morning insulin levels measured in the blood in patients with prediabetes. Almost half of patients in both groups increased testosterone blood level. According to the ICEF questionnaire, erectile function was significantly improved: in the group of patients with prediabetes: the ICEF-5 index prior to taking Tadalafil-SZ averaged 18.68 points (mild ED) whereas after taking the drug, a statistically significant increase in the ICEF index to an average of 23.02 points (p 0.05) was observed, which indicates the absence of erectile dysfunction in this group of patients during intake of Tadalafil-SZ. In the 2nd group of patients (with type 2 diabetes mellitus), the ICEF-5 index before treatment averaged 12.18 points, which reflects the average degree of erectile dysfunction, and at the end of the study there was a statistically significant increase in the ICEF-5 index to 18.44 points on average, which indicates a decrease in the severity of erectile dysfunction from moderate to mild (p 0.05). Overall Tadalafil-SZ is an effective treatment for erectile dysfunction in both patients with prediabetes and patients with type 2 diabetes mellitus.
BACKGROUND: Transrectal Doppler ultrasound is the leading method for studying blood flow in the prostate. Despite a significant number of studies on the use of ultrasound of the prostate in patients with BPH, many aspects of its clinical use remain unclear. One of these issues is the features of changes in blood flow in the prostate after transurethral surgical interventions. AIM: to assess the state of blood flow in the prostate gland in patients with BPH before and after transurethral enucleation by laser and bipolar methods. MATERIALS AND METHODS: The study included 88 patients with BPH aged 50 to 79 years who complained of urinary disorders. All patients underwent transurethral enucleation of BPH: 41 patients with the laser method (HoLEP) (1st group) and 47 patients with the bipolar method (TUEB) (2nd group). Before surgical treatment, 4, 12 and 24 weeks after surgery, patients underwent transrectal Doppler ultrasound of the prostate. RESULTS: The results of the study indicate a significant impact of surgery on the state of blood flow in the prostate gland. Examination 12 weeks after the operation showed a significant decrease in the peak blood flow velocity and values of the resistance index in patients of the 1st and 2nd groups compared with the corresponding values before the surgery and 4 weeks after the surgery. By 24 weeks after surgery, all patients showed normalization of blood flow parameters, while in patients of the 1st group (HoLEP) this process occurred faster than in patients of the 2nd group (TUEB). CONCLUSIONS: The high diagnostic efficiency and informativeness of transrectal Doppler ultrasound in the assessment of blood circulation in the prostate in patients with BPH has been confirmed. The blood flow velocity in the subcapsular and especially paraurethral arteries, as well as the values of the resistance index, were higher in patients with large prostates, which must be taken into account when planning surgical interventions.
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