Scientific journal
European Journal of Natural History
ISSN 2073-4972

INFRINGEMENTS OF HOMEOSTASIS OF LIPID AT PATIENTS WITH CHRONIC PYELONEPHRITIS

Rudichenko E.V., Novgorodtseva T.P., Antonjuk M.V.
Wide prevalence of chronic pyelonephritis, variability of current, the adverse forecast - all this causes necessity of early diagnostics and perfection of methods of treatment of this pathology. During recovery regress of clinical symptoms of disease outstrips normalization of metabolic infringements. Than more hardly and longly illness, backlog of metabolic remission from clinical is especially expressed. Among metabolic infringements which are one of the reasons of progressing chronic pyelonephritis, the role lipids and a condition of lipids peroxidation is widely discussed. Change of a functional condition antioxidant system and excessive activation of processes of lipids peroxidation creates the certain conditions for structural reorganization of lipids components of cellular membranes. Revealing probable variants of metabolic infringements is actual at chronic pyelonephritis, development pathogenesis the proved address methods of the regenerative therapy directed on metabolic correction.

The purpose of research - to study features of lipids homeostasis, processes of lipoperoxidation at patients with a chronic pyelonephritis in a phase of remission and a latent inflammation.

226 patients chronic pyelonephritis in a phase of remission (73,4 %) and in a phase of a latent inflammation (26,5 %) in the age of 48,9±0,8 years are surveyed. Among surveyed women (69,9 %) are prevailed. At 46,9 % secondary chronic pyelonephritis proceeded on a background nephrolytiasis. In research did not include patients with chronic renal failure and arteriosclerotic heart disease.

Research a spectrum of lipids of whey of blood and redistribution of structure phospholipids (PL) in red blood cells is lead. A condition of system of antioxidant protection (АОP) judged on an integrated parameter of antioxidant activity (АОА) of plasma of blood. An intensification of processes the lipids peroxidations estimated in red blood cells on increase malonic dialdehyde (MDA).

The analysis of structure of serum lipids in 53 % of cases has revealed its infringement. Distribution on types according to classification of Frederickson has shown, that for patients chronic pyelonephritis characteristic is dislipidemia IIа type. Redistribution of structure of phospholipids of red blood cells and fat acids (PA) included in them is established. The orientation of changes is expressed by decrease in a share of phosphotidilholine (PH) and sphingomieline (SM), increase phosphotidiletanolamine (PE) and phosphotidilserine (PS). The estimation of a condition of system the lipids peroxidation - АОЗ at 67,6 % surveyed has shown oppression of processes of lipoperoxidation. At 11,9 % of patients processes the lipids peroxidation were at a physiological level. The condition of hyperoxidation, expressing in increased level of MDA in blood has been revealed in 22,6 % of cases. The high factor МDA/АОА has testified about insufficiency of system AOS. Such condition of system the lipids peroxidations - АОS creates conditions for an aggravation of disease.

With the help of methods of the multivariate statistical analysis (factorial, cluster) three are allocated most frequently meeting clinic-metabolic a variant of metabolic infringements distinguished by character.

The first variant is characteristic for patients chronic pyelonephritis in a phase of remission and a latent inflammation with duration of disease till 5 years, rare aggravations (no more than 1 time one year), in whey of blood reveal the increased level of cholesterol of very low density lipoprotein (VLDL), in red blood cells - shares PS, total contents ω3, ω6 FA, a high level of nonsaturation, oppression of processes peroxidation on a background of high activity АОS.

The second variant meets at patients with chronic pyelonephritis in a phase of a latent inflammation the anamnesis of disease of 8 years, frequency of aggravations up to 2 times one year, in whey - hypercholesterolemia the easy degree, increased level VLDL, cholesterol of low density lipoprotein (LDL), are broken viscously - elastic properties of a membrane or red blood cells, ratio PH/PE caused by change, level МDA and parameter АОА are reduced.

The third variant is observed at patients chronic pyelonephritis in a phase of remission and a latent inflammation with duration of illness more than 8 years, frequency of aggravations up to 3 times one year is characteristic easy hypercholesterolemia, increased level of VLDL, LDL, deep metabolic changes of components of lipids of a cellular membrane - disbalanced structure FL and included in them ω3, ω6 FA on a background of the debalanced processes the lipids peroxidations - АОS.

The received results have clinical value for forecasting current chronic pyelonephritis and a choice of adequate methods of secondary preventive maintenance of disease. At carrying out of medical rehabilitation the differentiated therapy directed on correction of realization of metabolic infringements is expedient.

The article is admitted to the International Scientific Conference "Fundamental and applied research in medicine", China (Beijing), 26 November - 4 December, 2007, came to the editorial office on 09.11.07.