УДК: 616.33–089:616.71–007.234]–06–055.1–008.9

Introduction. The problem of osteoporosis (OP) has become an epidemic unprecedented in its scale. Numerous studies of various aspects of OP leave out men with a history of gastric resection (GR) as a result of complicated peptic ulcer disease (PUD). Therefore, a detailed characteristics of clinical parameters and hormonal and metabolic homeostasis in men with postgastric resection disease (PGRD) and comorbid OP will allow the improvement of the treatment and prevention of osteodeficiency conditions in this category of patients.

The aim of the study. To characterize clinical parameters and hormonal and metabolic homeostasis in men with postgastric resection disease and comorbid osteoporosis.

Materials and methods. 164 men with PGRD and comorbid OP were examined with preliminary random stratification by the presence of a history of five or more years of GR surgery as a result of complicated PUD. In addition to routine examinations, hormonal homeostasis was studied by the effect of hormones on protein metabolism: anabolic (growth hormone, parathyroid hormone, gastrin, and testosterone) and catabolic (triiodothyronine, thyroxine, glucagon, and cortisol) hormones and cyclic nucleotides. Plasma electrolytes and protein profile were also analyzed.

Results. It was established that the vast majority of patients who underwent the surgery with PGRD and comorbid OP have clinical signs of calcium metabolism disorders. They had significant abnormalities in hormonal and metabolic homeostasis manifested by dyshormonemia, dyselectrolytemia and dysproteinemia. We believe that these scientific facts will help to improve the treatment and prevention of secondary osteoporosis complications in this category of patients.

Conclusions. Among the clinical parameters in men with PGRD and comorbid OP, bone pain and muscle cramps prevailed. Hormonal homeostasis was characterized by dyshormonemia with a significant decrease in almost all studied anabolic hormones and an increase in almost all studied catabolic hormones. Deviations in metabolic homeostasis were manifested by dyselectrolytemia (hypophosphatemia, hypomagnesemia, decreased ionized calcium) and dysproteinemia (hypoalbuminemia, hyper-a₁-globulinemia, hyper-β-globulinemia, sharply reduced glycoproteins).

УДК: 615.5–002.525.2:616.1]–06–07

Introduction. Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease with numerous clinical manifestations that affects any organs or systems and requires a comprehensive study.

The aim of the study. To find out the clinical markers of the heart and blood vessels syntropic lesions in patients with SLE and evaluate their diagnostic value.

Materials and methods. The study included 118 patients with SLE with the presence of syntropic (having common etiological and/or pathogenetic mechanisms with the main disease) lesions of the heart and blood vessels (107 women (90.68%) and 11 men (9.32%) aged 18 to 74 years (average age 42.48 ±1.12 years)).

The study included the identification of clinical markers of syntropic lesions of the heart and blood vessels, determination of the diagnostic value of individual clinical markers and their constellations in terms of sensitivity, specificity and accuracy in patients with SLE, and the identification of one of them with the most reliable diagnostic value.

Results. Clinical markers for detecting mitral valve insufficiency in patients with SLE are morning stiffness, new rash, dyspnea, memory problems, presence of weakened cardiac sounds, systolic murmur on the apex of the heart, accent of the second sound on the pulmonary artery; mitral valve consolidation - new rash, the presence of legs edema, dyspnea, a feeling of interruptions in the work of the heart, pain in the heart area, the presence of weakened cardiac tones, systolic murmur on the top of the heart; myocarditis - muscle ache, alopecia, legs edema, shortness of breath , palpitation, systolic murmur on the top of the heart; pericardial effusion – legs edema, dyspnea, palpitations, the presence of weakened cardiac tones; endocarditis - the presence of the accent of the second tone on the pulmonary artery.

The optimal value for the diagnosis of mitral valve insufficiency in patients with SLE is the constellation of clinical markers "pain in the joints + new rash + accent of the second tone on the aorta"; of mitral valve consolidation - "dyspnea + a feeling of interruptions in the work of the heart"; of myocarditis - "heart palpitations + systolic murmur on the apex of the heart"; of pericardial effusion - "pain in the joints + weakening of heart tones"; of endocarditis - "fever + systolic murmur over the top of the heart + emphasis of the second tone on the pulmonary artery".

Conclusions. In patients with SLE the optimal value among clinical monomarkers and their constellations for the diagnosis of mitral valve insufficiency is dyspnea and the constellation "pain in the joints + new rash + accent of the second tone on aorta"; for MV consolidation - a complaint of a feeling of interruptions in the work of the heart and the constellation "shortness of breath + feeling of interruptions in the work of the heart"; for myocarditis - palpitations and the constellation "heartbeat + systolic murmur on the apex of the heart", pericardial effusion - the presence of weakened cardiac tones and the constellation "pain in the joints + weakened cardiac tones"; for endocarditis - accent of the second tone on the pulmonary artery and the constellation "fever + systolic murmur on the apex of the heart + accent of the second tone on the pulmonary artery". Constellations of clinical markers, but not individual clinical markers, have optimal value for the diagnosis of the syntropic heart lesions in patients with SLE.