asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2025-006asurgery-533Research ArticleАНГИОЛОГИЯANGIOLOGYПолипептиды в лечении пациентов с облитерирующим атеросклерозом артерий нижних конечностейPolypeptides in treatment of patients with obliterating atherosclerosis of the arteries lower extremitiesКривощековЕ. П.KrivoshchekovE. P.

Кривощеков Евгений Петрович, д.м.н., профессор, профессор кафедры хирургии с курсом сердечно-сосудистой хирургии института профессионального образования, 

443099, Самара, ул. Чапаевская, д. 89

Evgeny P. Krivoshchekov, Dr. Sci. (Med.), Professor, Professor of the Department of Surgery of the Institute of Postgraduate Education,

89, Chapaevskaya St., Samara, 443099

walker02@mail.ruКаторкинС. Е.KatorkinS. E.

Каторкин Сергей Евгеньевич, д.м.н., профессор, заведующий кафедрой и клиникой госпитальной хирургии,

443099, Самара, ул. Чапаевская, 89

Sergei E. Katorkin, Dr. Sci. (Med.), Professor, Head of Department and Hospital Surgery Clinic,

89, Chapaevskaya St., Samara, 443089

s.e.katorkin@samsmu.ruСамарский государственный медицинский университетРоссияSamara State Medical UniversityRussian Federation202509062025221110119Copyright © Кривощеков Е.П., Каторкин С.Е., 20252025Кривощеков Е.П., Каторкин С.Е.Krivoshchekov E.P., Katorkin S.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/533Введение

Введение. Лечение пациентов с хронической ишемией нижних конечностей на фоне облитерирующего атеросклероза должно быть направлено на восстановление нарушенной гемодинамики сосудистого русла. При атеросклерозе нарушение пептидного состава приводит к снижению способности сосудистой стенки препятствовать развитию патологических процессов. Назначение комплекса пептидов таким пациентам позволит восстановить эндотелиальную функцию артерий.

Цель

Цель. Оценить эффективность и безопасность использования препарата на основе полипептидов сосудов крупного рогатого скота у пациентов с облитерирующим атеросклерозом артерий нижних конечностей.

Материалы и методы

Материалы и методы. Исследование проведено в 2024 г.: 105 пациентов с хронической ишемией нижних конечностей IIA- и IIБ-степени на фоне облитерирующего атеросклероза. Мужчин – 96, женщин – 9, средний возраст 60 ± 5,6 и 70 ± 3,8 лет соответственно. Все пациенты получали консервативное лечение. В 1-й группе (n = 34) дополнительно – цилостазол; во 2-й группе (n = 35) – дополнительно сулодексид; в 3-й (основной) группе (n = 36) – дополнительно сулодексид по указанной выше схеме и полипептиды сосудов крупного рогатого скота.

Результаты

Результаты. Через 3 мес. от начала лечения во всех группах сохранялся хороший лечебный эффект. Через 6 мес. в 1-й и 2-й группах пациентов была отмечена отрицательная динамика. Потребовалось проведение повторных курсов консервативного лечения. Эти пациенты были исключены из дальнейшего исследования. В 3-й группе (полипептиды + сулодексид) лечебный эффект сохранялся в течение 9 мес. с начала лечения.

Обсуждение

Обсуждение. При невозможности выполнить реконструкцию артериального кровотока необходимо назначать препараты, повышающие реологические свойства крови, улучшающие непосредственный кровоток в пораженной конечности, а также положительно влияющие на метаболизм.

Выводы

Выводы. Включение в комплексное консервативное лечение пациентов с облитерирующим атеросклерозом артерий конечностей полипептидов сосудов крупного рогатого скота, являющегося пептидным регулятором, позволяет повысить его эффективность и значительно пролонгировать положительный лечебный результат.

Introduction

Introduction. Treatment of patients with chronic lower limb ischemia against the background of obliterating atherosclerosis should be aimed at restoring the impaired hemodynamics of the vascular bed. In atherosclerosis, a violation of the peptide composition leads to a decrease in the ability of the vascular wall to prevent the development of pathological processes.

Aim

Aim. To evaluate the efficacy and safety of using a drug based on bovine vascular polypeptides in patients with obliterating atherosclerosis of the lower limb arteries.

Materials and methods

Materials and methods. 105 patients with chronic lower limb ischemia of grades IIA and IIB against the background of obliterating atherosclerosis. There were 96 men and 9 women, the average age was 60 ± 5.6 and 70 ± 3.8 years, respectively. All patients received conservative treatment. In the 1st group (n = 34) additionally – cilostazol; in the 2nd group (n = 35) – additionally sulodexide; in the 3rd (main) group (n = 36) – additionally – sulodexide according to the above scheme and Polipeptydi.

Results

Results. After 3 months from the start of treatment, a good therapeutic effect was maintained in all groups. After 6 months, negative dynamics were noted in the 1st and 2nd groups of patients. Repeated courses of conservative treatment were required. These patients were excluded from further study. In the 3rd group (Polipeptyd + sulodexide), the therapeutic effect was maintained for 9 months from the start of treatment.

Discussion

Discussion. If it is impossible to reconstruct arterial blood flow, it is necessary to prescribe drugs that increase the rheological properties of the blood, improve direct blood flow in the affected limb, and also have a positive effect on metabolism.

Conclusions

Conclusions. The inclusion of Polipeptydm, a peptide regulator, in the complex conservative treatment of patients with obliterating atherosclerosis of the arteries of the extremities allows for an increase in its effectiveness and a significant prolongation of the positive therapeutic result.

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The authors declare that there are no conflicts of interest present.