Biliary system functional condition in patients with chronic cholecystitis against the background of diabetes mellitus type 2

L. Zhuravlyova, G. Tymoshenko
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Abstract

Overlay of diseases of the biliary system to diabetes mellitus type 2 can contribute to the enhancement of disorders of protein, lipid and carbohydrate metabolism and affect the mechanisms of regulation at the cellular molecular level. Therefore, the need for early diagnosis and study of the features of the course of chronic cholecystitis against the background of diabetes mellitus type 2 is a pressing issue of internal medicine. The motor-evacuation and cholecretory functions of the biliary system and the features of the course of chronic cholecystitis on the background of diabetes mellitus type 2 were studied. 93 patients were examined, of which 62 were patients with combined diabetes mellitus type 2 and chronic cholecystitis and 31 patients with isolated chronic cholecystitis. The control group was represented by 20 apparantly healthy individuals, who were representative of the age and number of male and female probands. The course of chronic cholecystitis was found to be accompanied by impaired gallbladder motor (evacuation) function, which was manifested by an increase in the latency period, the volume of the cavity of the gallbladder, the emptying coefficients in the dynamics and a decrease in the index of contraction of the gallbladder. In the presence of diabetes mellitus type 2, an atypical course of chronic cholecystitis may be formed, characterized by motor-evacuation disorders of the biliary tract and physico-chemical changes in bile, the severity of which exceeds those of isolated chronic cholecystitis. The peculiarities of the course of chronic cholecystitis in patients with diabetes mellitus type 2 are manifested by insignificant clinical symptoms and distinct changes at both stages of cholecystosonography, which may be the result of the development of autonomic neuropathy. In diabetes mellitus type 2, it is advisable to determine the status of the gallbladder (cholecystosonography) in order to prevent the risk of complications (cholelithiasis) and timely administration of antimicrobial therapy in the presence of an additional inflammation.
2型糖尿病背景下慢性胆囊炎患者的胆道系统功能状况
胆道系统疾病与2型糖尿病的叠加可导致蛋白质、脂质和碳水化合物代谢紊乱的增强,并影响细胞分子水平的调节机制。因此,早期诊断和研究2型糖尿病背景下的慢性胆囊炎的病程特点是内科急迫的课题。研究了2型糖尿病背景下的胆道系统运动排泄和胆道功能及慢性胆囊炎病程特点。共检查93例患者,其中2型糖尿病合并慢性胆囊炎62例,单纯性慢性胆囊炎31例。对照组由20名明显健康的个体代表,他们的年龄和数量具有代表性的男性和女性先证者。慢性胆囊炎病程中伴有胆囊运动(排空)功能受损,表现为潜伏期增大,胆囊腔体积增大,动力学排空系数增大,胆囊收缩指数降低。2型糖尿病可形成非典型的慢性胆囊炎病程,其特征是胆道运动排空障碍和胆汁的物理化学变化,其严重程度超过孤立的慢性胆囊炎。2型糖尿病慢性胆囊炎病程的特殊性表现为临床症状不明显,两期胆囊超声检查变化明显,这可能是自主神经病变发展的结果。在2型糖尿病患者中,建议确定胆囊的状态(胆囊超声检查),以防止并发症(胆石症)的风险,并在出现额外炎症时及时给予抗菌治疗。
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