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Актуальные вопросы профилактики рака желудка
Актуальные вопросы профилактики рака желудка
Успенский Ю.П., Барышникова Н.В., Краснов А.А., Петленко С.В., Апрятина В.А. Актуальные вопросы профилактики рака желудка. Consilium Medicum. 2022;24(5):358–364.
DOI: 10.26442/20751753.2022.5.201922
© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.
DOI: 10.26442/20751753.2022.5.201922
© ООО «КОНСИЛИУМ МЕДИКУМ», 2022 г.
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Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Профилактика рака желудка, как первичная, так и вторичная, является крайне важным компонентом ведения пациентов гастроэнтерологического профиля. Весьма актуальны правильный сбор анамнеза с оценкой вероятности развития наследственного (семейного) рака, устранение факторов риска (нарушенное питание, привычные/хронические интоксикации, ожирение, инфекция Helicobacter pylori и другие), а также применение гастропротекторов (в частности, препарата Регастим Гастро), особенно у лиц с потенциально предраковым состоянием – хроническим атрофическим гастритом. По данным двойного слепого плацебо-контролируемого рандомизированного исследования препарата Регастим Гастро (действующее вещество – альфа-глутамил триптофан) в терапии хронического атрофического гастрита установлено, что этот препарат обладает мощным противовоспалительным действием и регенераторной активностью. Прием препарата Регастим Гастро по сравнению с плацебо статистически значимо способствовал снижению количества клеток воспалительной инфильтрации на 1 мм2 слизистой оболочки желудка. В большей степени Регастим Гастро способствовал уменьшению эозинофильной (в 3 раза) и нейтрофильной (в 4 раза) инфильтрации слизистой оболочки желудка. Он также снижал количество макрофагов, лимфоцитов и плазмоцитов. Помимо противовоспалительных свойств препарат оказывал выраженный регенераторный эффект. На фоне приема Регастим Гастро имело место статистически значимое (р=0,028) увеличение количества желез на 1 мм2 слизистой оболочки желудка – на 26,1% в сравнении с исходными показателями скрининга. В группе пациентов, принимавших плацебо, напротив, отмечалось прогрессирование патологического процесса, сопровождавшееся снижением количества желез на 1 мм2 слизистой оболочки желудка после окончания лечения в сравнении с исходными показателями. После курса терапии у пациентов, принимавших препарат Регастим Гастро количество желез на 1 мм2 слизистой оболочки желудка было статистически значимо больше в сравнении с результатами в группе принимавших плацебо (р=0,013). Вследствие комплексного воздействия препарата отмечалось улучшение функциональных параметров слизистой оболочки желудка. После курса Регастим Гастро отмечалось улучшение кислотопродукции: смещение в кислую сторону среднего значения рН (в 1,6 раза) и повышение значения индекса кислотности как при сравнении с исходными значениями (в 5,4 раза), так и в сравнении с группой принимавших плацебо (в 2,9 раза). Назначение Регастим Гастро пациентам с гастритом, как H. pylori (+), так и H. pylori (-), еще до развития атрофии слизистой оболочки желудка с целью уменьшения фактора воспаления и предупреждения возникновения атрофии может иметь максимальную антиканцерогенную активность.
Ключевые слова: атрофия, рак желудка, гастропротекторы, альфа-глутамил-триптофан
Keywords: atrophy, stomach cancer, gastroprotectors, alpha-glutamyl-tryptophan
Ключевые слова: атрофия, рак желудка, гастропротекторы, альфа-глутамил-триптофан
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Keywords: atrophy, stomach cancer, gastroprotectors, alpha-glutamyl-tryptophan
Полный текст
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Авторы
Ю.П. Успенский1,2, Н.В. Барышникова*1,2,3, А.А. Краснов4, С.В. Петленко5, В.А. Апрятина6
1 ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России, Санкт-Петербург, Россия;
2 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России, Санкт-Петербург, Россия;
3 ФГБНУ «Институт экспериментальной медицины», Санкт-Петербург, Россия;
4 ФГБОУ ВО «Российский государственный педагогический университет им. А.И. Герцена», Санкт-Петербург, Россия;
5 ФГБУ «Научно-клинический центр токсикологии им. акад. С.Н. Голикова» ФМБА России, Санкт-Петербург, Россия;
6 АННО ВО «Научно-исследовательский центр “Санкт-Петербургский институт биорегуляции и геронтологии”», Санкт-Петербург, Россия
*baryshnikova_nv@mail.ru
1 Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia;
2 Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia;
3 Institute of Experimental Medicine, Saint Petersburg, Russia;
4 Herzen Russian State Pedagogical University, Saint Petersburg, Russia;
5 Golikov Research Clinical Center of Toxicology, Saint Petersburg, Russia;
6 Saint Petersburg Institute of Bioregulation and Gerontology, Saint Petersburg, Russia
*baryshnikova_nv@mail.ru
1 ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава России, Санкт-Петербург, Россия;
2 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава России, Санкт-Петербург, Россия;
3 ФГБНУ «Институт экспериментальной медицины», Санкт-Петербург, Россия;
4 ФГБОУ ВО «Российский государственный педагогический университет им. А.И. Герцена», Санкт-Петербург, Россия;
5 ФГБУ «Научно-клинический центр токсикологии им. акад. С.Н. Голикова» ФМБА России, Санкт-Петербург, Россия;
6 АННО ВО «Научно-исследовательский центр “Санкт-Петербургский институт биорегуляции и геронтологии”», Санкт-Петербург, Россия
*baryshnikova_nv@mail.ru
________________________________________________
1 Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russia;
2 Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia;
3 Institute of Experimental Medicine, Saint Petersburg, Russia;
4 Herzen Russian State Pedagogical University, Saint Petersburg, Russia;
5 Golikov Research Clinical Center of Toxicology, Saint Petersburg, Russia;
6 Saint Petersburg Institute of Bioregulation and Gerontology, Saint Petersburg, Russia
*baryshnikova_nv@mail.ru
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