EFFECT OF 3-HYDROXYPYRIDINE AND SUCCINIC ACID DERIVATIVES ON CHANGES IN THE CLINICAL MANIFESTATIONS OF AN EXACERBATION OF CHRONIC INFLAMMATORY DISEASES OF THE UTERUS AND ITS APPENDAGES DURING MEDICAL TREATMENT

Objective. To investigate the effects of Russian 3-hydroxypyridine and succinic acid derivatives (emoxipine, reamberine, and mexidol) on changes in the clinical symptoms of uncomplicated exacerbations of chronic inflammatory diseases of the uterus and appendages (CIDUA) versus those in endometrial leukocyte infiltration during conventional medical treatment. Subject and methods. A two-week prospective placebo-controlled simple single-blinded randomized trial was conducted to study the impact of weekly intravenous injection of emoxipine (150 mg/day), reamberine (400 ml/ day), and mexidol (300 mg/day) on changes in the clinical manifestations of uncomplicated exacerbations of CIDUA versus those in endometrial leukocyte infiltration during conventional medical therapy. The investigation included 124 women of reproductive age (17-45 years) who had been urgently admitted to the unit of gynecology for a diagnosed exacerbation of chronic endometritis (ICD-10 N71) or salpingo-oophoritis (ICD-10 N70). The ordinal rating scale for CIDUA exacerbation symptoms (CIDUAES) was used to evaluate the clinical status of the patients before and 2 weeks after therapy. Leukocyte infiltration values were estimated in the endometrial biopsy specimens in the same periods. Results. The course use of emoxipine, reamberine, and mexidol substantially improved the clinical status of women with CIDUA exacerbations. This manifested itself as a more pronounced reduction in the severity of genital and abdominal symptoms according to the CIDUAES scale as compared to the results of conventional treatment. 3-hydroxypyridine and succinic acid derivatives-induced clinical improvement in the patients was accompanied by an accelerated decrease in endometrial inflammatory infiltration. Emoxipine and mexidol caused a more marked drop in endometrial neutrophil and lymphocyte infiltration than reamberine. The test 3-hydroxypyridine and succinic acid derivatives induced an equal reduction in endometrial macrophage inf iltration and failed to produce any effect on changes in plasmocyte counts and reparative fibrosis values. Conclusion. The results of this investigation suggest that it is expedient to incorporate 3-hydroxypyridine and succinic acid derivatives (emoxipine, reamberine, and mexidol) into a combination treatment regimen for uncomplicated CIDUA exacerbations. This extended standard therapy can provide an accelerated resolution of an infectious and inflammatory process and concomitant clinical improvement in women with CIDUA.

exacerbations of chronic inflammatory diseases of the uterus and appendages, 3-hydroxypyridine and succinic acid derivatives, severity of clinical symptoms, endometrial inflammatory infiltration