RU-2861333-C1 - METHOD FOR TREATING ATHEROSCLEROSIS

RU2861333C1RU 2861333 C1RU2861333 C1RU 2861333C1RU-2861333-C1

Abstract

FIELD: medicine. SUBSTANCE: invention relates to therapy and can be used in the treatment of atherosclerosis. the method involves administering antibiotics, immunomodulators and heparin. over a course of 10-14 days, 3 daily endolymphatic infusions are carried out with intervals of 1-2 hours between them, sequentially in separate syringes: heparin 2000 IU in 5 ml of saline at the beginning of each infusion, cefepime 1 g in 15 ml of saline in each infusion, clindamycin 600 mg/4 ml in 15 ml of saline in each infusion, polyoxidonium 6 mg in 10 ml of saline in the first daily infusion, cycloferon 250 mg/2 ml in 20 ml of saline in the first daily infusion, heparin 1000 IU in 5 ml of saline at the end of each infusion. for endolymphatic infusion, a peripheral lymphatic vessel on the inner surface of the upper third of the lower leg or the middle third of the thigh is used. EFFECT: improving blood circulation in the area of ischaemia caused by atherosclerotic lesion, maintaining therapeutic concentrations of the used drugs in the structures of the lymphatic system and in the bloodstream throughout the entire course of treatment for 10-14 days. 1 cl, 1 tbl

Inventors

Kharitonov Vitalij Viktorovich
Esipov Aleksandr Vladimirovich
PAVLOV ALEKSANDR IGOREVICH
Kislenko Andrej Mikhajlovich
GONCHAROV EVGENIJ ALEKSANDROVICH
KOZLOVSKIJ ARKADIJ PAVLOVICH

Dates

Publication Date: 20260505
Application Date: 20250326

Claims (2)

1. A method for treating atherosclerosis, including the administration of antibiotics, immunomodulators and heparin, characterized in that 3 daily endolymphatic infusions are administered over a course of 10-14 days with breaks of 1-2 hours between them, sequentially in separate syringes: heparin 2000 IU in 5 ml of saline at the beginning of each infusion, cefepime 1 g in 15 ml of saline in each infusion, clindamycin 600 mg / 4 ml in 15 ml of saline in each infusion, polyoxidonium 6 mg in 10 ml of saline in the first daily infusion, cycloferon 250 mg / 2 ml in 20 ml of saline in the first daily infusion, heparin 1000 IU in 5 ml of saline at the end of each infusion, while for endolymphatic Infusions are performed using the peripheral lymphatic vessel of the inner surface of the upper third of the leg or the middle third of the thigh.
2. The method for treating atherosclerosis according to paragraph 1, characterized in that different syringes are used for the endolymphatic administration of each of the drugs, changing the rate of administration using an infusion pump depending on the diameter of the vessel, while for a vessel diameter in the range of 0.2-0.3 mm, the rate is limited to 12-20 ml/hour, and for a vessel diameter in the range of 0.3-0.4 mm - at a rate of 21-30 ml/hour.

Description

Field of technology The invention relates to medicine, namely to clinical lymphology, and can be used to treat patients with atherosclerosis of various localizations. Atherosclerosis is a multifactorial disease affecting muscular and muscular-elastic arterial vessels, characterized by the development of degenerative changes in the walls of large arteries with the formation of atherosclerotic plaques (AP) and subsequent narrowing of the lumen of the vessels, limiting the blood supply to vital organs and body parts, including the heart, brain, kidneys, and lower extremities. Several etiologic theories of atherosclerosis are discussed in the literature, particularly the lipid and thrombogenic theories [1]. Therefore, in atherosclerosis, the generally accepted treatment approach is primarily the use of lipid-lowering drugs and agents that correct the hemorheological and hemocoagulation properties of the blood. These therapies have resulted in a significant reduction in the incidence of vascular accidents such as heart attacks, strokes, and local occlusions, but without significant changes in the lumen diameter of vessels affected by atherosclerosis [2]. At the same time, there is numerous convincing data on the involvement of various microorganisms in the initiation and subsequent development of atherosclerosis: Chlamydia pneumoniae, Chlamydia trachomatis, Streptococcus spp, cytomegalovirus infection, herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), and the Epstein-Barr virus [3, 4]. This justifies the possibility of increasing the effectiveness of atherosclerosis treatment when included in a comprehensive antimicrobial therapy regimen. A method is known based on the use of the antibiotic azithromycin in the treatment regimen of patients with atherosclerotic lesions of the coronary vessels against the background of signs of infection with Chlamydia pneumoniae [5]. It was found that the use of azithromycin in patients also suffering from diabetes mellitus, the incidence of cardiovascular events in the form of myocardial infarction during 14 months of observation was 14.6%, while in the subgroup of patients with diabetes mellitus taking placebo, their incidence reached 53%. In coronary atherosclerosis complicated by other nosologies, the differences were also positive, but less significant. The presented data allowed us to consider this method as the closest analogue of the proposed method for the treatment of atherosclerosis. As a disadvantage, it should be noted that the cited work did not use the endolymphatic route of administration, which allows for the creation of higher concentrations of the drug in the body's tissues over a long period of time - a day or more. The essence of the invention The proposed method aims to improve the effectiveness of treatment aimed at correcting changes in arterial vessels resulting from the atherosclerotic process, including those caused by infectious factors. It is based on the current clinical guidelines of the Russian Ministry of Health from 2023 [6], which include the use of lipid-lowering drugs and antiplatelet agents. However, unlike prior art solutions, the new method proposes the daily administration of antibiotics, immunomodulators, and heparin, administered as endolymphatic infusions into a peripheral lymphatic vessel on the inner surface of the upper third of the leg or middle third of the thigh. Antibiotics belonging to the carbapenem or third- or fourth-generation cephalosporin groups are used in combination with lincosamides. For example, meropenem (a carbapenem) may be selected at a dose of 1 g in 15 ml of saline with clindamycin (a lincosamide) at a dose of 600 mg/4 ml in 15 ml of saline per infusion. Alternatively, cefotaxime or cefepime (a third- or fourth-generation cephalosporin) may be selected at a dose of 1 g in 15 ml of saline in combination with clindamycin (a lincosamide) at a dose of 600 mg/4 ml in 15 ml of saline. Heparin is administered at the beginning and end of each infusion at a dose of 2000 IU and 1000 IU in 5 ml of saline, respectively. As immunomodulators, drugs with detoxifying, antioxidant and anti-inflammatory properties are selected, namely, polyoxidonium is used at a dose of 6 mg in 10 ml of saline in combination with cycloferon at a dose of 250 mg/2 ml in 20 ml of saline. Endolymphatic administration of medications is performed using an infusion pump. A separate syringe is used for each infusion. The infusion rate is selected based on the vessel diameter. For vessels with diameters of 0.2-0.3 mm, the rate is limited to 12-20 ml/hour; for vessels with diameters of 0.3-0.4 mm, the rate is set at 21-30 ml/hour. Three infusions are administered daily, with 1-2 hour intervals between each, over a course of 10-14 days. The course dose and frequency are determined by the clinical presentation and instrumental and functional examination data. The distinctive properties of this method are aimed at creating and maintaining therapeutic drug