Assessment of Proteinase-Inhibitory System and Plasma Fibrinolytic Activity in Patients with Gastroesophageal Reflux Disease and Diabetes Mellitus Type 2
Aim: investigation of proteinase-inhibitory system and plasma fibrinolytic activity in patients with gastroesophageal reflux disease (GERD) combined with diabetes mellitus (DM) type 2. Methods. The study involved 112 patients with GERD aged 33 to 76 years, who subsequently were divided into groups depending on the form of GERD. The state of proteinase-inhibitory blood system was evaluated by K.N. Veremeyenko et al.. The state of enzymatic and non-enzymatic fibrinolysis in plasma was evaluated by N. Titsa method. Results. We found that patients with erosive form of GERD independent on DM type 2 more likely have higher level of low molecular and macromolecular proteins lysis as well as collagen lysis compared to the healthy person and patients with non-erosive form of GERD (p < 0.05). The changes in the concentration of α2-MG in GERD were multidirectional: reduced concentration of α2-MG in GERD combined with DM type 2, and vice versa, increased level of α2-MG in patients with GERD without comorbid pathology compared with the healthy person. Assessment of plasma fibrinolytic activity found that patients with erosive form of GERD combined with DM type 2 had significantly increased fibrinolytic activity compared to the healthy person (p < 0.05), and in patients with nonerosive form of GERD and DM type 2 just had trend to increase in these indicators (p > 0.05). Novelty. First studying changes of proteolytic and fibrinolytic activity of blood and inhibitor of proteolysis allowed reveal new mechanisms of pathogenesis and progression of GERD in patients with DM type 2. Conclusion. Thus, in patients with GERD combined with DM type 2 met unbalanced growth of the intensity of proteolysis under the conditions of reduced expression of its inhibitor, increased plasma fibrinolytic activity.
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