Modern approaches to the diagnosis of dyscirculatory encephalopathy in patients with chronic pancreatitis
DOI:
https://doi.org/10.24144/2415-8127.2018.58.125-129Keywords:
chronic pancreatitis, dyslipidemia, dyscirculatory encephalopathy.Abstract
The development of numerous diseases, in particular chronic pancreatitis, is associated with progressive ischemia of the pancreas due to atherosclerosis of the vessels. Atherosclerotic lesions of brachiocephalic vessels are also one of the main causes of dyscirculatory encephalopathy. Even latent (the form of encephalopathy significantly impairs the quality of patients` life, adversely affects professional activity, the role in the family and society, causes emotional distress. In connection with this, an important task is the early diagnosis of cognitive impairments with the aim of timely treatment and secondary prevention of their progression. The aim of the research is to investigate the diagnostic possibilities of application of psychometric and laboratoryinstrumental research methods for determining the severity of dyscirculatory encephalopathy in patients with combination of chronic pancreatitis and atherosclerosis. Materials and methods. 64 patients with chronic pancreatitis were examined. All patients underwent biochemical blood test, lipidogram and calculation of the atherogenicitycoefficient, ultrasound examination of brachiocephalic vessels. The presence of cognitive impairment was evaluated using psychometric methods that included a scale for assessing mental status (MMSE) and the Montreal Cognitive Assessment Scale (MoCA). Results. In all patients with chronic pancreatitis, in combination with dyslipidemia, changes were found due to duplex scans of the neck vessels. In patients with chronic pancreatitis without laboratory changes in the lipidogram, the same indicators were at lower normal limit and statistically significantly differed from those of the control group. Clinical manifestations of MMSЕ dyscirculatoryencephalopathy in patients showed the following: the latent form of circulatory encephalopathy was detected in 7 patients in group I (23.3%) and 9 patients in group ІІ (26.5%). Moderate cognitive impairment (mild dementia) was noted in 3 patients in group ІІ (8.8%). There was no disturbances of mental status in rest of the patientbased on the MMSE scale (26-30 points). According to the Montreal scale, cognitive impairment was noted in 6 patients in the second group (17.6%). Conclusion. In patients with combination of chronic pancreatitis and atherosclerosis, deeper disorders of the higher nervous activity function and more pronounced changes in ultrasound duplex scan of the neck vessels are observed, than in patients with chronic pancreatitis without atherosclerotic disorders.
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