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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rmt</journal-id><journal-title-group><journal-title xml:lang="ru">Общая реаниматология</journal-title><trans-title-group xml:lang="en"><trans-title>General Reanimatology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1813-9779</issn><issn pub-type="epub">2411-7110</issn><publisher><publisher-name>FSBI "SRIGR" RAMS</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.15360/1813-9779-2017-2-52-60</article-id><article-id custom-type="elpub" pub-id-type="custom">rmt-1585</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СЕПСИС</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SEPSIS</subject></subj-group></article-categories><title-group><article-title>Эффективность сочетанного применения антиоксиданта и глютамина при абдоминальном сепсисе</article-title><trans-title-group xml:lang="en"><trans-title>The Effectiveness of Combined Use of Antioxidant and Glutamine in Abdominal Sepsis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Назаретьян</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Nazaretyan</surname><given-names>V. V.</given-names></name></name-alternatives><email xlink:type="simple">viktoria.nazaretyan@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лукач</surname><given-names>В. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Lukach</surname><given-names>V. N.</given-names></name></name-alternatives><email xlink:type="simple">viktoria.nazaretyan@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Куликов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kulikov</surname><given-names>A. V.</given-names></name></name-alternatives><email xlink:type="simple">viktoria.nazaretyan@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Воронежская городская клиническая больница скорой медицинской помощи № 1</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Voronezh city clinical hospital of emergency medical care № 1</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Омский государственный медицинский университет Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Omsk State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>29</day><month>06</month><year>2017</year></pub-date><volume>13</volume><issue>2</issue><fpage>52</fpage><lpage>60</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Назаретьян В.В., Лукач В.Н., Куликов А.В., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Назаретьян В.В., Лукач В.Н., Куликов А.В.</copyright-holder><copyright-holder xml:lang="en">Nazaretyan V.V., Lukach V.N., Kulikov A.V.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.reanimatology.com/rmt/article/view/1585">https://www.reanimatology.com/rmt/article/view/1585</self-uri><abstract><p>Цель исследования: выявление эффективности сочетанного применения антиоксидантной терапии мексидолом и дополнительной нутритивной поддержки глутамином больных при абдоминальном сепсисе (АС). Материал и методы. В исследование включили 170 больных с абдоминальным сепсисом, которых разделили на 2 группы. Больные группы 1 (группа сравнения, n=70) получали базовое лечение. Больных груп" пы 2 (основная группа, n=100) разделили на 2 подгруппы. В подгруппе 21 больные (n=70) в дополнение к базовому лечению получали внутривенно капельно мексидол (2000 мг/сут) и дипептивен (27,5 г/сут), больные подгруппы 22 (n=30) еще и глутамин per os. Анализ выживаемости проводили методом Каплана-Мейера с использованием для проверки статистических гипотез F-критерия Кокса и критерия Кокса-Ментела. Результаты. Анализ результатов лечения показал, что в основной группе 2 летальность была ниже, чем в группе сравнения 1. Выявили статистически значимое увеличение кумулятивной доли выживших при использовании мексидола и глютамина. Заключение. Сочетанное внутривенное введение препаратов мексидола и дипептивена оказывало положительное влияние на результат лечения больных с абдоминальным сепсисом. Основываясь на результатах анализа можно предположить, что эта пара прерывает каскад развития абдоминального сепсиса и способствует выходу из критического состояния.</p></abstract><trans-abstract xml:lang="en"><p>Aim of the study: the effectiveness of concomitant use of antioxidant therapy with antioxidant 2-ethyl-6- methyl-3-hydroxypyridine succinate (mexidol) and intensive nutritional support with glutamine in patients with abdominal sepsis (AS). Materials and methods. 170 patients with abdominal sepsis (AS) involved in the study were separated into two groups. Patients of group 1 (control group, n=70) received basic treatment. Patients from group 2 (n=100) were divided into 2 subgroups. Patients from the subgroup 21 (n=70), in additon to the basic treatment, received intravenously, by drop infusion, mexidol (2000 mg per day) and dipeptiven (27.5 g per day), patients from subgroup 22 (n=30) additionally to that received per os glutamine. Survival analysis was carried out according to the Kaplan-Meier method with using of the Cox's F-test and Mantel-Cox test for testing of statistical hypotheses. Results. Treatment outcomes analysis showed that in the basic group 2, mortality was lower than in the control group 1. A statistically significant increase of cumulative part in the survivors was revealed using mexidol and glutamine. Conclusion. Concomitant intravenous administration of medications had positive effects on treatment outcomes. Following on from the analysis results, we may suggest that the pair mexidol + dipeptiven interrupts the cascade of development of abdominal sepsis and contributes to avoiding a critical condition during sepsis.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>человек</kwd><kwd>абдоминальный сепсис</kwd><kwd>метаболическая терапия</kwd><kwd>анализ выживаемости</kwd><kwd>метод Каплана-Мейера</kwd></kwd-group><kwd-group xml:lang="en"><kwd>human</kwd><kwd>abdominal sepsis</kwd><kwd>metabolic therapy</kwd><kwd>survival analysis</kwd><kwd>Kaplan-Meier method</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гусев Е.Ю., Черешнев В.А. Системное воспаление: теоретические и методологические подходы к описанию модели общепатологичес" кого процесса. Часть 1. Общая характеристика процесса. Патол. физиология и эксперим. терапия. 2012; 4: 3–14.</mixed-citation><mixed-citation xml:lang="en">Gusev E.Yu., Chereshnev V.A. Systemic inflammation: theoretical and methodological approaches to description of general pathological process model. Part I. General characteristic of the process. Patologicheskaya Fiziologiya i Eksperimentalnaya Terapiya. 2012; 4: 3–14. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Гусев Е.Ю., Черешнев В.А. Эволюция воспаления. Цитокины и вос паление. 2012; 11 (4): 5–13.</mixed-citation><mixed-citation xml:lang="en">Gusev E.Yu., Chereshnev V.A. Evolution of inflammation. Tsitokiny i Vospalenie. 2012; 11 (4): 5–13. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Козлов В.К. Сепсис: этиология, иммунопатогенез, концепция со" временной иммунотерапии. Киев: Анна"Т; 2007: 296.</mixed-citation><mixed-citation xml:lang="en">Kozlov V.K. Sepsis: etiology, immunopathogenesis, concept of modern immunotherapy. Kiev: Anna"T; 2007: 296. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Повзун С.А. Важнейшие синдромы: патогенез и патологическая анатомия. СПб.: КОСТА; 2009: 480.</mixed-citation><mixed-citation xml:lang="en">Povzun S.A. The most important syndromes: pathogenesis and patho" logical anatomy. Sankt"Peterburg: KOSTA; 2009: 480. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Савельев B.C., Гельфанд Б.Р. (ред.). Сепсис: классификация, клини" ко"диагностическая концепция и лечение. Практическое руковод" ство. М.: МИА; 2013: 360.</mixed-citation><mixed-citation xml:lang="en">Savelyev V.S., Gelfand B.R. (eds.). Sepsis: classification, clinical and diagnostic concept, and treatment. Practice guidelines. Moscow: Meditsinskoe Informatsionnoe Agentstvo; 2013: 360. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Lagu T., Rothberg M.B., Shieh M.S., Pekow P.S., Steingrub J.S., Lindenauer P.K. Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007. Crit. Care Med. 2012; 40 (3): 754–761. http://dx.doi.org/10.1097/CCM.0b013e318232db65. PMID: 21963582</mixed-citation><mixed-citation xml:lang="en">Lagu T., Rothberg M.B., Shieh M.S., Pekow P.S., Steingrub J.S., Lindenauer P.K. Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007. Crit. Care Med. 2012; 40 (3): 754–761. http://dx.doi.org/10.1097/CCM.0b013e318232db65. PMID: 21963582</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Levy M.M., Artigas A., Phillips G.S., Rhodes A., Beale R., Osborn T., Vincent J.L., Townsend S., Lemeshow S., Dellinger R.P. Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: a prospective cohort study. Lancet Infect. Dis. 2012; 12 (12): 919–924. http://dx.doi.org/10.1016/S1473"3099(12)70239"6. PMID: 23103175</mixed-citation><mixed-citation xml:lang="en">Levy M.M., Artigas A., Phillips G.S., Rhodes A., Beale R., Osborn T., Vincent J.L., Townsend S., Lemeshow S., Dellinger R.P. Outcomes of the Surviving Sepsis Campaign in intensive care units in the USA and Europe: a prospec" tive cohort study. Lancet Infect. Dis. 2012; 12 (12): 919–924. http://dx.doi.org/10.1016/S1473"3099(12)70239"6. PMID: 23103175</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Vincent J.L., Abraham E. The last 100 years of sepsis. Am. J. Respir. Crit. Care Med. 2006; 173 (3): 256–263. http://dx.doi.org/10.1164/rccm. 200510"1604OE. PMID: 16239619</mixed-citation><mixed-citation xml:lang="en">Vincent J.L., Abraham E. The last 100 years of sepsis. Am. J. Respir. Crit. Care Med. 2006; 173 (3): 256–263. http://dx.doi.org/10.1164/rccm. 200510"1604OE. PMID: 16239619</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Wischmeyer P.E. The evolution of nutrition in critical care: how much, how soon? Crit. Care. 2013; 17 (Suppl 1): S7. http://dx.doi.org/ 10.1186/cc11505. PMID: 23514524</mixed-citation><mixed-citation xml:lang="en">Wischmeyer P.E. The evolution of nutrition in critical care: how much, how soon? Crit. Care. 2013; 17 (Suppl 1): S7. http://dx. doi.org/10.1186/cc11505. PMID: 23514524</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Бажина Е.С., Никулин А.В., Хорошилов С.Е. Экстракорпоральные ме" тоды лечения абдоминального сепсиса. Общая реаниматология. 2015; 11 (5): 45–66. http://dx.doi.org/10.15360/1813"9779"2015"5"45"66</mixed-citation><mixed-citation xml:lang="en">Bazhina E.S., Nikulin A.V., Khoroshilov S.E. Extracorporeal treatments for abdominal sepsis. Obshchaya Reanimatologiya = General Reanimatology. 2015; 11 (5): 45–66. http://dx.doi.org/10.15360/ 1813"9779"2015"5"45"66</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Кудрявцев А.Н., Кулабухов В.В., Чижов А.Г. Выбор режима гемо" фильтрации при сепсисе. Общая реаниматология. 2016; 12 (2): 43–55. http://dx.doi.org/10.15360/1813"9779"2016"2"43"55</mixed-citation><mixed-citation xml:lang="en">Kudryavtsev A.N., Kulabukhov V.V., Chizhov A.G. The selection of hemofiltration regimen in sepsis. Obshchaya Reanimatologiya = General Reanimatology. 2016; 12 (2): 43–55. http://dx. doi.org/10.15360/1813"9779"2016"2"43"55. [In Russ., In Engl.]</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Зильбер А.П. Этюды респираторной медицины. М.: МЕДПресс"ин" форм; 2007: 792.</mixed-citation><mixed-citation xml:lang="en">Zilber A.P. Sketches of of respiratory medicine. Moscow: MEDPress" inform; 2007: 792. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Грицук С.Ф., Безруков В.М. Синдром аминокислотного дисбаланса и метаболическая дисфункция при критических состояниях в хи" рургии. Вестн. интенс. терапии. 2004; 2: 10–13.</mixed-citation><mixed-citation xml:lang="en">Gritsuk S.F., Bezrukov V.M. Syndrome of amino acid imbalance and metabolic dysfunction in critical conditions in surgery. Vestnik Intensivnoi Terapii. 2004; 2: 10–13. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Гусев Е.Ю., Зотова Н.В., Лазарева М.А. Цитокиновый ответ и дру" гие отличительные особенности критических фаз системного вос" паления при сепсисе. Мед. иммунология. 2014; 16 (2): 173–182.</mixed-citation><mixed-citation xml:lang="en">Gusev E.Yu., Zotova N.V., Lazareva M.A. Cytokine response and other differences between critical phases of sepsis"associated systemic inflammation. Meditsinskaya Immunologiya. 2014; 16 (2): 173–182. https://doi.org/10.15789/1563"0625"2014"2"173"182. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Реброва О.Ю. Статистический анализ медицинских данных: при" менение пакета прикладных программ STATISTICA. 3"е изд. М.: МедиаСфера; 2006: 305.</mixed-citation><mixed-citation xml:lang="en">Rebrova O.Yu. Statistical analysis of medical data: application software package STATISTICA. 3"rd ed. Moscow: MediaSfera; 2006: 305. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Черешнев В.А., Гусев Е.Ю., Зотова Н.В. Фундаментально"приклад" ные аспекты системного воспаления с позиции теории физиологи" ческих и типовых патологических процессов. Рос. физиол. журн. им. И.М. Сеченова. 2010; 96 (7): 696–707. PMID: 20973174</mixed-citation><mixed-citation xml:lang="en">Chereshnev V.A., Gusev E.Yu., Zotova N.V. Fundamental"applied aspects of systemic inflammation in terms of physiologic and typical pathological process. Rossiisky Fiziologichesky Zhurnal Imeni I.M. Sechenova. 2010; 96 (7): 696–707. PMID: 20973174. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Скулачев В.П. Энергетика биологических мембран. М.: Наука; 1989: 564.</mixed-citation><mixed-citation xml:lang="en">Skulachev V.P. Energy of biological membranes. Moscow: Nauka; 1989: 564. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Шифрин А.Г., Горенштейн М.Л. Восстановление биоустойчивости при сепсисе. Запорожье: Эксперт; 2004: 300.</mixed-citation><mixed-citation xml:lang="en">Shifrin A.G., Gorenshtein M.L. Recovery of biostability in sepsis. Zaporozhye: Ekspert; 2004: 300. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Novak F., Heyland D.K., Avenell A., Drover J.W., Su X. Glutamine sup" plementation in serious illness: a systematic review of the evidence. Crit. Care Med. 2002; 30 (9): 2022–2029. http://dx.doi.org/10.1097/ 00003246"200209000"00011. PMID: 12352035</mixed-citation><mixed-citation xml:lang="en">Novak F., Heyland D.K., Avenell A., Drover J.W., Su X. Glutamine sup" plementation in serious illness: a systematic review of the evidence. Crit. Care Med. 2002; 30 (9): 2022–2029. http://dx.doi.org/10.1097/ 00003246"200209000"00011. PMID: 12352035</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Peterson M.D., Rhea M.R., Alvar B.A. Maximizing strength develop" ment in athletes: a meta"analysis to determine the dose"response rela" tionship. J. Strength Cond. Res. 2004; 18 (2): 377–382. http://dx. doi.org/10.1519/00124278"200405000"00031. PMID: 15142003</mixed-citation><mixed-citation xml:lang="en">Peterson M.D., Rhea M.R., Alvar B.A. Maximizing strength development in athletes: a meta"analysis to determine the dose"response relationship. J. Strength Cond. Res. 2004; 18 (2): 377–382. http://dx.doi.org/ 10.1519/00124278"200405000"00031. PMID: 15142003</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Цветков Д.С. «Иммунное» питание: новые возможности коррек" ции метаболических нарушений у больных в критических состоя" ниях. Эффективная фармакотерапия. 2014; 6: 28–35.</mixed-citation><mixed-citation xml:lang="en">Tsvetkov D.S. Immunonutrition: new opportunities of treatment of metabolic disorders in critically ill patients. Effektivnaya Farmakoterapiya. 2014; 6: 28–35. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Верижникова Е.В., Доронинко Л.М. Применение препарата Мекси" дол в интенсивной терапии пациентов с мультиорганной недоста" точностью. Бюл. эксперим. биологии и медицины. 2006; приложение 1: 104–107.</mixed-citation><mixed-citation xml:lang="en">Verizhnikova E.V., Doroninko L.M. Application of Mexidol in intensive care of patients with multiorgan failure. Byulleten Eksperimentalnoi Biologii i Meditsiny. 2006; приложение 1: 104–107. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Воронина Т.А. Мексидол: основные нейропсихотропные эффекты и механизм действия. Фарматека. 2009; 6: 35–38.</mixed-citation><mixed-citation xml:lang="en">Voronina T.A. Mexidol: main neuropsychotropic effects and mecha" nisms of action. Farmateka. 2009; 6: 35–38. [In Russ.]</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Звягин А.А., Родионова С.С. Фармоконутриенты при парентераль" ном питании больных сепсисом (обзор литературы). Вестн. ин тенс. терапии. 2011; 4: 23–29.</mixed-citation><mixed-citation xml:lang="en">Zvyagin A.A., Rodionova S.S. Pharmaconutrients in parenteral nutri" tion of patients with sepsis (review). Vestnik Intensivnoi Terapii. 2011; 4: 23–29. [In Russ.]</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
