Остеоартроз та комбінована патологія: особливості патогенезу (огляд літератури)

Abstract

The purpose of the study. Identification of key links in the pathogenesis, which will improve the diagnostic and treatment approaches in such patients. Materials and methods. Analytical and bibliosemantic methods were used in the research. Results. Modern scientists are actively discussing the problems of providing medical care to patients who, in addition to the underlying disease, have an aggravating effect of concomitant, combined pathology. Interestingly, in the publications of domestic literature we find the terms "combined", "concomitant", "combined" pathology. The English-speaking scientific community uses the terms - "comorbidity" when it comes to damage to 2 organs or systems and "multimorbidity" when more than 3 diseases. The problem of combined pathologies is one of the key in modern medicine. Osteoarthritis is one of the most common diseases in Ukraine and around the world. Exhausting degenerative-dystrophic pathology, which is combined with high personal and socio-economic burden. According to the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Society for the Study of Osteoarthritis (OARSI), it is known that a middle-aged patient with osteoarthritis has 4 combined pathologies, including In addition to osteoarthritis, up to 8 other chronic diseases are diagnosed in old age. In clinical practice, a combination of this disease with hypertension and type 2 diabetes is often observed. However, there are still many differences in the opinion of scientists about the pathogenesis of osteoarthritis with combined pathologies. Conclusions. Scientific research in the modern world is aimed at studying the complex relationships between diseases that are often found in combination in the same patient. During the research the data of modern domestic and foreign literature were reviewed and analyzed and data on new ideas of common links in the pathogenesis of osteoarthritis, arterial hypertension and type 2 diabetes mellitus, which combines disorders in the system of oxidant-antioxidant, protease-antiprotease imbalance, proteolytic and fibrinolytic activities of blood plasma, changes in endothelial function, impaired mineral metabolism, the impact of vitamin D deficiency on the further development of chronic inflammation with the activation of cytokine synthesis. The information presented in the review is a reason to assume that the combined pathologies show the potential for complicating each other, complicating the diagnosis and treatment tactics