FIELD: medicine; cardiology.
SUBSTANCE: scheme of examination and treatment of patients with a metabolic syndrome (MS) consists in the following. In the presence of AG with average degree of cardiovascular risk in a combination to visceral adiposity and: overweight<27 kg/m2, during 3-6 month prescribe non-medicament actions referred on treatment of adiposity, at achievement of AD target level after the specified term, non-medicament actions continue; with overweigth≥27 kg/m2 or combination of overweigth≥27 kg/m2 and hyperglycemias on an empty stomach, during 3-6 month, prescribe Orlistat and-or Metforminum, at achievement after the specified term of target level of a AD, continue the therapy; with combination overweigth≥27 kg/m2, hyperglycemias on an empty stomach and glucose tolerance during 3-6 month, prescribe acarbose or Orlistat and acarbose in a combination with Metforminum, at achievement after the specified term of target AD level, continue the therapy; in combination of overweight≥27 kg/m2, hyperglycemias on an empty stomach, glucose intolerance and lipidemia during 3-6 month, prescribe Orlistat in a combination with Metforminum or acarbose, at achievement of AD target level after the specified term, continue the therapy. In the presence of AG with high degree of cardiovascular risk in combination with visceral adiposity and: overweight<27 kg/m, prescribe non-medicament actions referred on treatment of obesity, and the antihypertensive combined therapy; overweight≥27 or combination of overweight≥27 kg/m2 and hyperglycemias on an empty stomach, prescribe Orlistat and-or Metforminum, and the antihypertensive combined therapy; with overweight≥27 kg/m2, hyperglycemias on an empty stomach and glucose intolerance, prescribe the antihypertensive combined therapy in a combination with acarbose or Orlistat and acarbose together with Metforminum; with overweight≥27 kg/m2, hyperglycemias on an empty stomach, glucose intolerance and lipidemia, prescribe the antihypertensive combined therapy in combination with Orlistat and Metforminum or acarbose; with lipidemia, glucose intolerance, prescribe the antihypertensive combined therapy in a combination with Orlistat or acarbose; SD 2, and also lipidemia, glucose intolerance, a plasma glucose on an empty stomach < 6,0 mmol/l, prescribe the antihypertensive combined therapy in a combination with orlistate or akarbose; SD 2, and also a lipidemia broken by tolerance to a glucose, plasmatic glucose on an empty stomach > 6,0 mmol/l, prescribe the antihypertensive combined therapy in a combination with preparations decreasing amount of sugar in blood. Affecting only on one of the MS components, it is possible to achieve appreciable improvement due to indemnification of changes in other links of its pathogenesis.
EFFECT: use of the offered algorithms of treatment of patients with a metabolic syndrome will allow optimising their treatment.
12 cl, 2 tbl, 2 ex
