Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya31932Editorial articleПередовая статьяReview ArticleNutritional status in patients with chronic pancreatitisСтатус питания больных хроническим панкреатитомMaevI VМаевИ ВKucheryavyiYu AКучерявыйЮ АAndreevD NАндреевД НBideevaT VБидееваТ В«Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России15022016882VOL 88, NO2 ()ТОМ 88, №2 (2016)818910042020Copyright ©; 2016, Consilium MedicumCopyright ©; 2016, ООО "Консилиум Медикум"2016Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/31932

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas, accompanied by damage to the functioning parenchyma and ducts to develop irreversible structural changes (fibrosis, calcification) and irreparable loss of the endocrine and exocrine functions of this organ. Maldigestion is a typical outcome of CP of any etiology with a long-term history. Fat malabsorption is considered as a basis for malnutrition in patients with CP. The severity of malnutrition in patients with CP correlates with three major pathogenetic factors: primary nutrient deficiency, pancreatic maldigestion and secondary malabsorption syndrome (nutrient loss), hypermetabolism that is caused by an inflammatory process in the pancreas and that determines the severity of the disease. Malnutrition in patients with CP is not just a complication of this disease, but has an important impact on its course. Patients with severe malnutrition are noted to have the significantly lower activity of pancreatic enzymes in the duodenal contents, feces, and blood, which is correlated with the smaller blood amount of total protein and albumin.

Аннотация Хронический панкреатит (ХП) — воспалительное заболевание поджелудочной железы (ПЖ), сопровождающееся повреждением функционирующей паренхимы и протоков с развитием необратимых структурных изменений (фиброз, кальцификация) и невосполнимой утерей эндо- и экзокринной функции этого органа. Мальдигестия является типичным исходом ХП любой этиологии с длительным анамнезом. Основой мальнутриции у пациентов с ХП считается мальабсорбция жира. Тяжесть мальнутриции у больных ХП коррелирует с тремя основными патогенетическими факторами: первичный дефицит питательных веществ, панкреатическая мальдигестия и вторичный синдром мальабсорбции (потеря питательных веществ), гиперметаболизм, обусловленный воспалительным процессом в ПЖ и определяющий тяжесть заболевания. Развитие нутритивной недостаточности у больных ХП является не просто осложнением этого заболевания, мальнутриция оказывает важное влияние на его течение. У больных с тяжелой мальнутрицией отмечается достоверное снижение активности панкреатических ферментов в дуоденальном содержимом, кале, крови, коррелирующее со снижением количества общего белка и альбумина в крови.

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