Особенности течения и лечения ревматоидного артрита у женщин в климактерии

Аннотация

Objects of inquiry: 107 women with rheumatoid arthritis in climacteric period. Aim of inquiry: studying clinical-immunologic and roentgenologic indices in females with rheumatoid arthritis in connection with climacteric periods and perfecting therapeutic approaches. Methods of inquiry: clinical studies, assessment of pain syndrom under visual analogous scale (VAS), determination of pro-inflammatory cytokins in blood scrum, roentgendensitometry, determination of body mass index, gravity of climacteric syndrom under modified menopausal index, determination of osteosyndrom by Ritchie and Lee test. Results achieved and their novelty: for the first time in RA women in climacteric an interrelation between clinical laboratory RA manifestations and an expression of reproductivity disorders has been revealed. An interplay between acute phase indices, rheumatoid arthritis and Lee test and grade of severity of climatcric period has been established. An intcraggravating effect of RA and climacteric syndrom was approved. Predictive valuable factors in RA women in climacteric were determined. Osteoporosis in females with RA was began earlier before climacteric, it lasted more pronounced with lowering mineral density of bones. An advancing lowering of mineral density of bones in RA began in climacteric was shown. Dependance between a level of pro-inflammatory cytokins and duration of disease has been revealed, and less expressed regression of IL-ip indices in women with preserved menstrual function. Recommendations for strategy of RA treatment in women in climacteric taking into consideration features of a course of disease were worked out. Practical value: rocngcnometry in females with RA, determination of TNF-a, IL-ip cytokins, modified menopausal index by Kuppermann contributed to diagnosis and prediction, management of an adequate therapy. Using of plasmapheresis and climadinon in complex therapy of rheumatoid arthritis reduced manifestations of disease and climacteric syndrom. An implementation degree and economic efficacy: results of studies were implemented into activities of the Republican Arthrology Center, Specialized Qualified Ambulance Treatment, departments of Rheumatology, Cardiorhcumatology, 1st clinic of the Tashkent Medical Academy, in teaching process on a department of Faculty & Hospital Therapy, Oriental Medicine and Internal Diseases of the medico-preventive faculty. A field of application: Internal Diseases, Rheumatology