RU2331416C1 - Method for enhancement of thrombocyte antioxidant proofness in arterial hypertension cases with metabolic syndrome - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to haematology, cardiology, and endocrinology; it can be applied to enhancement of thrombocyte antioxidant proofness in arterial hypertension cases with metabolic syndrome. For this purpose individually chosen low energy diet and graduated exercise are included in therapy. Also drug preparations valsartan by 80 mg every morning and trimethazidin by 1 pill twice a day are administered.

EFFECT: elimination of hemostasis system complications in arterial hypertension cases with metabolic syndrome.

3 tbl, 1 ex, 2 dwg

Description

The invention relates to medicine, namely to hematology, cardiology and endocrinology.

The literature contains recommendations on the appointment of a low-calorie diet and physical training for metabolic correction in the metabolic syndrome (Almazov V.A., Blagosklonnaya Y. V., Shlyakhto E.V., Krasilnikova E.I. Metabolic cardiovascular syndrome. St. Petersburg. : Publishing House of St. Petersburg State Medical University. 1999. - 208 pp.) And reducing the degree of abdominal obesity, which is its component, with the help of recommendations more focused on the use of hypocaloric diet (Savelyeva L. Modern approaches to the treatment of obesity. // Doctor, 2000 , No. 12, - p. 12-14; Kadyrova R.KH ., Salkhanov B.A. Nutrition for obesity. Alma-Ata: Kazakhstan, 1990) or physical training (Moshkov V.N. Physical education for obesity. M .: Medicine ″, 1976. - 56 p.).

In people with arterial hypertension (AH) with metabolic syndrome (MS), valsartan is used as a hypotensive agent, and trimetazidine as a metabolite.

However, previously a complex of a hypocaloric diet, dosed physical activity, valsartan and trimetazidine was not used to correct the antioxidant protection of platelets in individuals with hypertension in MS.

The aim of the invention is the correction of antioxidant protection of platelets in patients with hypertension in MS.

The essence of the proposed method lies in the fact that for the correction of antioxidant protection of platelets in people with hypertension with MS for at least 3 months, an individual hypocaloric diet, dosed physical activity, valsartan once a day in the morning and trimetazidine in two doses in the morning and evening are prescribed.

The method is characterized in that using several technically simple and not requiring expensive reagents, equipment, labor and time methods, early correction of lipid peroxidation (LPO) and antioxidant protection of platelets is possible and the risk of platelet formation in people with hypertension in MS is eliminated, capable of leading without the application of the developed treatment complex to thrombophilic thrombocytopathy with the occurrence of thrombosis of various vessels.

Upon completion of the treatment measures, a second examination of the LPO and antioxidant protection is possible in order to control the adequacy of the measures taken.

The inventive method is as follows. Blood is taken from a vein in an amount of 20 ml through a thick needle by gravity into a test tube. As a corsenvant, a 5% Trilon-B solution is used at the rate of 1.5 ml of preservative per 20 ml of whole blood. Then, the blood with the preservative is carefully and thoroughly mixed and centrifuged at 1000 rpm for 10 minutes to precipitate red blood cells and white blood cells. The supernatant, which contains the bulk of the platelets, is aspirated into a separate tube and centrifuged at 1000 rpm for 10 minutes. In this case, the red blood cells and leukocytes remaining in the supernatant are sedimented. The precipitate was removed and the supernatant was placed in a separate tube and centrifuged at 2200 rpm for 15 minutes. The result is a pellet consisting of platelets alone. The platelet output is 1.5 × 10 ⁹ -2.5 × 10 ⁹ cells from 20 ml of whole blood. The resulting platelets are washed as follows. The non-residual liquid after the third centrifugation is removed, and 6 ml of a 0.85% sodium chloride solution prepared in a 2.7% solution of Trilon B are added to the platelet pellet. The blood platelet is gently mixed and centrifuged at 2200 rpm for 10 minutes. Then the supernatant is removed, and physiological saline on Trilon B in the same quantities is again added to the precipitate. This procedure is repeated three times. It should be noted that the isolation and washing of platelets is carried out at room temperature. Part of the cells during the washing process is lost and the number of platelets isolated from 20 ml of whole blood, as a result, averages 1.8 × 10 ⁹ cells. In each case, the platelet count is calculated in the Goryainov’s cell.

Subsequent assessment of the activity of catalase and SOD is carried out in the following way.

Determination of catalase in the blood. The principle of the method is that catalase destroys the H ₂ O ₂ substrate, and the remaining undamaged portion of hydrogen peroxide is measured using sodium molybdate. As is known, molybdenum is characterized by the formation of peroxide compounds of the composition Na ₂ MoO ₆ , which have a yellow color, when interacting with hydrogen peroxide. The color intensity of the resulting molybdenum peroxide compounds depends on the amount of hydrogen peroxide in the solution, i.e. from the activity of catalase in the sample.

Reagents

(1) 0.3% aqueous hydrogen peroxide solution (1 ml of a concentrated hydrogen peroxide solution was adjusted with distilled water to 100 ml).

(2) 4% aqueous solution of sodium molybdate.

Table 1.
Scheme for determining catalase in the blood Injectable Reagents Idle test Test sample The solution of N ₂ About ₂ ml 2,000 2,000 Platelet Suspension, ml - 0.010 Molybdate solution, ml 1,000 1,000

Table 1 describes the methodology.

A molybdate solution is added to each sample separately, and immediately after stirring the reaction mixture, the extinction at 410 nm is measured against distilled water. The extinction of a blank sample is about 0.350. The more catalase in the sample, the less hydrogen peroxide remains intact and the less molybdate peroxide is formed. The result is evaluated by the degree of destruction of hydrogen peroxide by catalase or the degree of blocking the formation of the final products of molybdate peroxides and expressed as a percentage. The calculation is carried out according to the formula:

where E _{x. pr} and E _iss.pr - extinction, respectively, single and test samples. Using the calibration curve constructed for standard solutions of catalase (figure 1), evaluate the activity of catalase in the sample based on the calculated percentage of destruction of hydrogen peroxide. Catalase activity is attributed to the platelet concentration (in ME / 10 ⁹ tr.) In the studied platelet suspension.

Catalase activity in ME / 10 ⁹ tr. Is plotted on the abscissa axis of the scheme, and blocking of the reaction in% on the ordinate axis.

Definition of SOD. The principle of determination is based on the reduction of nitrotetrosolium by superoxide radicals, which are formed during the reaction between phenazine methasulfate and the reduced form of nicotinamidine nucleotide (NAD · H). The formation of nitroformazan, a nitrotetrazolium reduction product, is blocked by the presence of SOD in the sample. So, based on the amount of nitroformazan, you can evaluate the activity of SOD.

Reagents

(1) 0.15 M phosphate buffer (pH 7.8) (4.48 g Na ₂ HPO ₄ , 0.25 g KH ₂ PO _{4 are} dissolved in 500 ml of distilled water).

(2) Incubation mixture of 37 mg EDTA-Na ₂ , 330 mg of nitrotetrazolium blue, 5 mg of phenazine methasulfate is mixed with 300 ml of phosphate buffer, left to stand overnight. Filter in the morning.

(3) NAD · H solution (152 mg of NAD · H was dissolved in 10 ml Tris-EDTA buffer).

(4) Tris-EDTA buffer, pH 8.0 (37 mg EDTA-Na, 24 mg Tris are dissolved in 100 ml of distilled water).

SOD is determined in a platelet suspension (Table 2).

Table 2.
Scheme for determining SOD. Additive Reagents Idle test Test sample Incubation mixture, ml 1,500 1,500 Distilled water, ml 0,100 - Platelet Suspension, ml - 0,100 NAD · H solution, ml 0,050 0,050

Mix and make stand at room temperature and measure the extinction of the blank and test samples at 540 nm on a spectrophotometer. The extinction of a blank is about 0.680. The calculation is made according to the formula:

SOD activity is determined using a calibration curve (figure 2). SOD activity in blood is expressed in ME / 10 ⁹ tr. SOD activity in ME / 10 ⁹ tr is plotted on the abscissa axis of the scheme, and blocking of nitrotetrazolium recovery in% is plotted on the ordinate axis.

Definition of MDA. The level of MDA was determined by the thiobarbitar method in washed and resuspended platelets, the principle of the method is Smith I. B., Jngenrian S. M., Silver M. I. Malondialdehyde formation as an indicator of prostaglandin production by human platelet. // J. Lab. Clin. Med. - 1976. - Vol. 88. - No. 1. - P.167-172 as modified by A. Kubatiev, S. Andreev Lipid peroxides and thrombosis. // Bulletin of experimental biology. - 1979. - No. 5. - p. 414-417.

The production of MDA in a cell suspension was induced by adding 10-20 μl of thrombin to a suspension of 0.5 ml of the suspension under stirring conditions (thrombin concentration 4 mg / ml). The sample was incubated with thrombin for 5 minutes. Then added 0.5 ml of 50% trichloroacetic acid in 1 N HCl and 0.5 ml of 0.9% thiobarbituric acid. Immediately after mixing the reagents, the sample was placed in a boiling water bath for 15-30 minutes. After that, it was cooled at room temperature and centrifuged at 3000 rpm.

The supernatant was photometric at λ = 532 nm. The control was a sample in which 0.5 ml of physiological saline was added. To assess the initial level of MDA, the extinction of the sample was determined without the addition of thrombin. The calculation was carried out according to the formula:

ε is the extinction of the sample

1,5 · 10 ⁵ - the coefficient of molar extinction

3 - factor considered breeding

10 ⁹ - conversion coefficient in nm

The concentration of MDA in terms of 10 ⁹ platelets was determined as follows:

C (nM · 10 ⁹ platelets) = ε · 2 · 10 ² / N

N is the number of platelets in μl divided by 100,000.

Table 3
Antioxidant blood parameters in the examined people Examined Category Number of observations Catalase MELO ⁹ tr SOD ME / 10 ⁹ tr MDA nmol / 10 ⁹ tr Healthy people 64 10500.0-8900.0 2000.0-1350.0 0.40-0.85 Patients with hypertension and developing MS 73 5200.0-8899.0 1150.0-1349.0 0.86-1.20 Patients with hypertension with an existing at least 1/2 year MS 85 3700.0-5199.0 820.0-1149.0 1.21-1.60

Thus, with the use of several technically simple and not requiring expensive reagents, equipment, labor and time methods, early detection of the risk of platelet formation in humans is possible, which can lead without thrombophilic thrombocytopathy with the occurrence of thrombosis of various vessels. With an increase in MDA in platelets to 0.86 nmol / 10 ⁹ tr. and higher, reducing catalase to 8901.0 IU / 10 ⁹ tr. and lower and SOD up to 1349.0 IU / 10 ⁹ tr. and below, to normalize these parameters, it is necessary to prescribe for 3 months a treatment complex consisting of an individually selected hypocaloric diet, dosed physical activity, valsartan and trimetazidine.

To create a negative energy balance in the body of patients, they are recommended an individually selected hypocaloric diet.

The caloric content of the daily diet individually for each patient with MS is calculated in kcal according to the formula:

for women 18-30 years old (0.0621 × body weight, kg + 2.0357) × 240,

31 years - 60 years (0.0342 × body weight, kg + 3.5377) × 240,

over 60 years old (0.0377 × body weight, kg + 2.7545) × 240,

for men 18-30 years old (0.0630 × body weight, kg + 2.8957) × 240,

31 years - 60 years (0.0484 × body weight, kg + 3.6534) × 240,

over 60 years old (0.0491 × body weight, kg + 2.4587) × 240.

The coefficient obtained remains unchanged with minimal physical activity, multiplied by 1.3 for moderate and 1.5 for high physical activity (as a rule, in patients with MS the level of physical activity is low).

3 main meals and 2 intermediate meals are recommended. With the regular skipping of one of the main meals, the frequency of obesity increases significantly, a positive correlation between obesity and skipping breakfast is also revealed. The following daily calorie distribution is recommended: breakfast - 25%, 2nd breakfast - 10%, lunch - 35%, afternoon tea - 10%, dinner - 20%.

To compile the patient’s menu, special tables are used with indications of the chemical composition and calorie content of the products, given that the main sources of energy are proteins (1 g contains 4 kcal), fats (9 kcal), carbohydrates (4 kcal) and alcohol (7 kcal).

The second component of the proposed method is feasible regular physical training.

In real life conditions, it is possible to carry out three forms of physical activity: 1) morning hygienic gymnastics (exercise); 2) therapeutic and preventive gymnastics; 3) fractional physical exercises throughout the day.

1. Morning hygienic gymnastics (exercise).

Morning exercises should be done after sleep before breakfast in a ventilated room. Under the influence of classes, the body is freed from the state of inhibition of physiological processes that occurs during sleep.

The sequence of exercises involves alternating the load on various muscle groups (arms, legs, body). Exercises are performed with a gradually increasing excursion of breathing, stretching, limited use of force conditions. The breathing during exercises should be free, rhythmic, without delay, mainly through the nose; the exhalation should be longer than the inhalation (inhalation 2-3 s, exhale 3-5 s).

With good health, the load can be strengthened by the number of repetitions, speeding up the pace, increasing the amplitude of movements and reducing pauses between exercises.

With fatigue, you should reduce the load, increase the duration of pauses between exercises, fill them with calm breathing.

After gymnastics, you need to go to a wipe or take a shower.

Morning exercises should cause a sense of vitality, increased activity, better health and performance.

If you feel unwell, develop shortness of breath or pain in the heart and behind the sternum, you should temporarily interrupt classes and consult a doctor.

During the day, patients with MS are recommended preventive gymnastics. Depending on the initial training, it is possible to use at the beginning of a lightened version of physical activity, and subsequently a strengthened version.

2. Complexes of therapeutic and preventive gymnastics for persons suffering from MS.

2.1. A lightweight version of therapeutic gymnastics.

Exercise 1. Standing. Walking is calm with a gradual acceleration and deceleration of 1-2 minutes. During the exercise, a gradual deepening of breathing.

Exercise 2. Circular movements in the shoulder joints. When breeding - inhale, while mixing - exhale with a slight tilt of the body and retraction of the abdominal wall - 6-8 times. Fingers touch shoulders, elbows pressed to the body.

Exercise 3. Standing, hands on the belt. Alternately transferring the severity of the body from one leg to the other with slight bending of the legs in the knee joint, without taking the feet off the floor. Do the exercise 10-16 times with muscle tension in the legs.

Exercise 4. Standing, legs spaced shoulder width apart, hands on the belt. Torso forward, touch left sock with your right hand. 4-6 times alternately. When the position is straightened, inhale; when tilted, exhale. Looking forward.

Exercise 5. Standing, arms along the torso. At the same time, take straight arms and one leg to the sides with alternating leg abductions. 4-6 times in each direction alternately. A wave of arms and legs, breathing free, do not hold.

Exercise 6. Standing, legs to the sides, hands in front of the chest, palms down. With the turn of the body, spread your arms to the sides with the turn of the palms up - inhale. Return to the starting position with a slight tilt of the body forward - exhale. 3-5 times in each direction alternately. Coordinate breathing with the movement of the body and hands. By the end of the exhalation, retract the wall of the abdomen.

Exercise 7. Standing, hands free. Walking freely - 1 min, then with high flexion of the hips - 10-20 movements, followed by a transition to a quiet walk - 1-2 minutes. Rhythmic breathing, medium depth.

Exercise 8. Sitting on the edge of the chair, hands on the waist. Bending back and bending forward of the body. Repeat 6-10 times. Do not hold your breath.

Exercise 9. Sitting on the edge of the chair, focus with tassels on the edge of the chair, and with your feet somewhat in front of the chair. Squats with an emphasis on the edge of the chair - 4-6 times. When squatting, exhale.

Exercise 10. Standing sideways to the back of the chair, hold on to it with one hand. Swing your free straight arm with your legs back. Return to starting position. Repeat 4-6 times with each hand and foot. Do not hold your breath.

Exercise 11. Standing, legs apart, arms at the waist. Turns the body to the right and left - 6-10 times alternately. Do not turn your head, look forward.

Exercise 12. Standing, legs together, arms down. To spread your arms to the sides - inhale, bend your leg at the knee and press your hands to your stomach - exhale. 3-5 times each leg in turn. Strive to maintain balance; as you exhale, draw in your stomach.

Exercise 13. Standing, legs together, hands down. Lateral slopes of the body with bending of the opposite arm ("pump"). Do not hold your breath, strive for a greater excursion of movement.

Exercise 14. Standing. Walking is calm with uniform breathing of medium depth. 1-2 minutes

Exercise 15. Lying on a rug with a pillow placed under the head. Go to the half-sitting position and hug the bent hips - exhale, return to the starting position - inhale. Do not hold your breath. Strive in a half-sitting position to maintain balance. Run 4-6 times.

Exercise 16. Lying, arms to the sides, legs apart. Semicircular movements with the right straight leg to the left with the turn of the pelvis - exhale - return to the starting position - inhale. 3-5 times in each direction. Alternately left and right with the greatest possible excursion of the leg movement, while maintaining the emphasis of the hands on the floor.

Exercise 17. Sitting on the floor; a) get on all fours; b) move to a kneeling position; c) raise your hands up - inhale, tilt the body, and take your hands back - exhale. When tilting, belly retract. Repeat 4-6 times; e) move to a standing position, and the son-in-law to a lying position; f) self-massage of the abdomen with small semicircular movements in a clockwise direction - 1-2 minutes. Rest 2 min; g) calm breathing; h) exercise in protruding (calm) and retracting (active) the abdominal wall. Combine abdominal retraction with expiration through the mouth. Repeat 4-6 times.

Exercise 18. Standing, arms bent. Vigorous walking on the spot or in a room with high flexion of the hips and waved arms - 20-30 steps. Do not hold your breath.

Exercise 19. Sitting on a chair, legs apart, hands on the waist or rest against the edge of the chair. Circular movements of the pelvis with retraction of the abdomen when the pelvis is brought back. 4-6 times in each direction.

Exercise 20. Standing. Calm walking with breathing of an average depth of 2-3 minutes.

With the initial sufficient training or exercise tolerance arising during the classes, the following set of exercises can be used.

2.2. A reinforced version of therapeutic gymnastics.

Exercise 1. Standing. Walking calm with rubbing the palms of the chest, abdomen, lower back. It takes 1-2 minutes.

Exercise 2. Standing, arms down. Simultaneous bending with tension and free “throwing” of arms forward, to the sides and up 12-16 times. When bending, exhale; when leveling, inhale.

Exercise 3. Standing, arms at the waist, legs shoulder width apart. Lateral movements of the pelvis to the right and left, back and forth. It is performed 6-10 times alternately. Breathing is free.

Exercise 4. Standing, feet shoulder width apart, arms down. Circular movements of straight arms in the shoulder joints, 6-10 times with maximum excursion, do not hold your breath.

Exercise 5. Standing, arms in front of the chest, bent at the elbows. Walking with high flexion of the hips, with the touch of hands. 6-10 times each leg in turn. The movements are vigorous, while flexing the thigh - exhale through the mouth.

Exercise 6. Walking calm 1-2 minutes.

Exercise 7. Sitting on the edge of the chair, hands on the waist. Bending and bending of the body. The exercise is performed 8-10 times. The movements are energetic. When straightening, inhale; when bent, exhale.

Exercise 8. Standing sideways to a chair, hold on to the back, the other hand at the waist. Alternating swings with a straight leg forward with the greatest possible excursion. Leg sweep combined with exhalation. It is carried out 4-6 times.

Exercise 9. Standing, legs apart, arms to the sides. Tilts the body forward with a touch of the right brush of the left toe of the foot, the other hand is pulled up. Return to starting position. Combine the slope with the exhale, while straightening, inhale 4-6 times.

Exercise 10. Walking calm with breathing of medium depth. 1-2 minutes

Exercise 11. Standing, hands in a fist and lowered: a) bending the arms at the elbows with force and unbending them with the retraction back with the greatest possible straightening and tension and a delay in tension for 2-3 seconds. Standing, hands on the waist; b) half-squats, followed by lifting on toes and straining the legs. The exercise is performed 4-6 times with the greatest possible rectification and tension and a delay in the stress state for 2-3 seconds.

Exercise 12. Sitting on the edge of a chair. In the position of the leg raised and bent at the knee joint, alternately shake the tibia and thigh muscles with the hands. Reduce muscle tension. 1-2 minutes

Exercise 13. Sitting on the edge of the chair, straight legs divorced. Breeding and mixing straight arms and legs. When breeding, inhale, while mixing, exhale. It is carried out 4-8 times.

Exercise 14. Standing. Walking is calm with the transition to rhythmic calm running (jogging) in place or with movement. If tired, go for a walk with moderate breathing. 2-5 minutes

Exercise 15. Lying on the mat. Simultaneous lifting of the body and legs as you exhale. 4-6 times. Arms and legs straightened, keep balance.

Exercise 16. Lying on the mat, emphasis with brushes on the floor. Cross movement with straight legs - “scissors”. 4-8 times. Do not hold your breath.

Exercise 17. With a quick straightening of the legs, move to a sitting position, then lie down. You can help with a wave, 4-6 times.

Exercise 18. Lying on your back, legs bent. Calm breath 4-6 times.

Exercise 19. Lying on your back, arms spread apart with the emphasis of the hands on the floor. With the turn of the pelvis to the left, bend the legs, turn the pelvis with the legs crossed to the right and stretch the legs. Repeat such circular movements with legs 3-6 times in each direction alternately. Do not tear your hands off the floor. Do not hold your breath.

Exercise 20. Lying on your back, arms and legs apart. Alternate turns of the body to the right and left with the laying of one hand on the other. Do not move your legs. With arms apart, inhale, while turning, exhale. It is carried out 3-6 times.

Exercise 21. Lying on your back, arms along the body: a) turn on your left side; b) turn on the right side; c) go to the supine position; d) get on your knees; e) move to a standing position; f) walking in a place with high hip flexion and arm movement - 20-30 steps; g) sit on the mat; h) lie on your back, calm breathing. Repeat the whole complex 3-4 times.

Exercise 22. Standing. Walking calm with breathing of medium depth - 1-2 minutes. Exercise 23. Standing, legs spaced the width of the foot, hands on the waist. Circular motion of the pelvis, right and left 6-8 times. Do not hold your breath.

Exercise 24. Standing with legs wide apart, hands in front of the chest. Alternately bending the leg with the transfer of body weight to it with stretching the arms to the toe of the bent leg. 4-6 times in each direction. The other leg is straight. When straightening - inhale, while tilting - exhale.

Exercise 25. Standing, legs spaced shoulder width apart, arms at the waist. Circular head movements 4-10 times in each direction.

Exercise 26. Standing, legs spaced shoulder-width apart, arms at the waist. Tilt the body to the right, pulling the left hand up - inhale. Return to starting position - exhale. 4-6 times alternately.

Exercise 27. The same, arms to shoulders. Circular movements of the hands with a maximum excursion in the shoulder joints, when breeding - inhale, while reducing and retracting the walls of the abdomen - exhale. The breath is deep.

Exercise 28. Standing. Calm walking and breathing of medium depth. Reduced overall load. 1-2 minutes

3. Fractional exercise throughout the day.

A patient with MS is a patient with a number of concomitant disorders and, above all, the cardiovascular system. This circumstance limits the simultaneous use of great physical activity in the process of morning gymnastics, as well as in the main occupation of therapeutic and prophylactic gymnastics. That is why an increase in the physical activity of people suffering from MS should be carried out by distributing physical activity in small doses throughout the day. This method of increasing the physical activity of patients with MS should be considered as a fractional load method.

Depending on the real life conditions of patients with MS suffering from various degrees of abdominal obesity, various exemplary fractions of various loads can be recommended to increase physical (motor) activity throughout the day.

Option 1.

Exercise 1. Sitting - spread your elbows to the sides - inhale, stretch your arms forward with tension - exhale, 4-6 times.

Exercise 2. Sitting - stand up with the deflection of the body and sit down - 8-10 times.

Exercise 3. Sitting - an imitation of the movements of a boxer with a possibly large rotation of the body - 10-12 times.

Option 2

Exercise 1. Standing - walking with high hip flexion - 16-30 times.

Exercise 2. Standing - circular movements of the head to the right and left - 3-8 times in each direction.

Exercise 3. Standing - legs spread apart - imitation of the movement of the pigtail - 10-12 times.

Exercise 4. Sitting - transition to a standing position - 10-12 times.

Option 3

Exercise 1. Walking is calm - 1 min.

Exercise 2. Walking accelerated - 1 min.

Exercise 3. Walking with a high flexion of the hips and alternate wave of hands 20-30 times.

Exercise 4. Walking calm with breathing - 1-2 minutes; the run is calm on the spot or with movement around the room - 2-5 minutes.

Option 4

Walking walk of various extent.

Option 5

Physical labor in various versions and of various durations depending on the conditions (cleaning the premises, home maintenance, work on cleaning the territory, garden works, etc.).

Patients are also prescribed for 3 months valsartan 80 mg once a day in the morning and trimetazidine 1 tablet 2 times a day.

Example. Patient K., 42 years old, with a body weight of 89.0 kg, a body mass index of 31.6 kg / m ² , suffering from metabolic syndrome for 6 years, when examined in platelets, a decreased catalase activity of 4000.0 IU / 10 ⁹ was recorded tr., SOD 930.0 IU / 10 ⁹ tr. and an increased MDA content of 1.55 nmol / 10 ⁹ tr.

The patient was prescribed an individually selected hypocaloric diet (2480.4 kcal), individually selected physical activity, valsartan 8 mg in the morning and trimetazidine 1 tablet 2 times a day. The patient was examined monthly after the start of treatment. Simultaneously with the examination, a study was conducted of the activity of SOD, catalase and the content of MDA in platelets.

By the end of 3 months of treatment, the patient's body weight decreased (79.0 kg) and body mass index (28.1 kg / m), and LPO and the antioxidant platelet system were normalized (catalase 9400.0 IU / 10 ⁹ tr., SOD 2200.0 IU / 10 ⁹ tr., Platelet MDA 0.45 nmol / 10 ⁹ tr.), Which eliminated the risk of thrombocytopathic. The patient was recommended to follow these recommendations in the future.

The use of this method of correcting the antioxidant protection of platelets in hypertensive patients with MS in the clinic will help to avoid many vascular complications, reduce the number of cases of temporary disability in them, reduce the duration of hospitalization, and reduce disability and mortality.

Claims (1)

A method for enhancing the antioxidant protection of platelets in patients with arterial hypertension with metabolic syndrome, including a treatment complex of an individually selected hypocaloric diet, dosed physical activity, valsartan 80 mg once a day in the morning and trimetazidine 1 tablet 2 times a day.

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