In the process of evolution of the calcium was elected by nature to act as a mediator and regulator of various metabolic processes, functions of cells. Homeostasis of calcium in the body depends on the same conditions as in the cage. The main that determined the organization of calcium metabolism, is the narrow range of physiological changes in the cell, which is located in areas of very low levels. The most important regulators of metabolism belongs to the liver. It participates in the selection of bile toxic and biologically active substances and products of metabolism. Calcium plays an exceptionally important role in the mechanism of the formation of bile as coefficients and complex secret. Calcium not only significantly affect the secretion of bile acid and lipid complexes, but also dramatically changes the excretory processes in the liver. Summarising the above data, we can state a variety of effect of calcium on the metabolic processes that determine the gainnot only secretory and excretion liver function. Exchange of calcium in excretion system has a number of distinctive features. First of all it is connected with its significant concentration in the gall bladder. Thus the development of diseases of the liver system may contribute to a negative effect on calcium homeostasis. The aim of the study was to investigate changes in the metabolism of calcium, which leads to the development of osteopenia and osteoporosis in patients on chronic acalculous cholecystitis with concomitant hypertension disease. We examined 102 patients with chronic acalculous cholecystitis, among whom 87 had a concomitant hypertension disease. The study showed that in all groups decreased the calcium content in the serum, while in the group with combined pathology in most -2,17±0,03 (р <0,001). Thus, as chronic acalculous cholecystitis, hypertension disease to changes in calcum metabolism, which is manifested by hypocalcemia, the mechanism of which is in these different nosological forms. Significant difference in the indicators between groups were found. At the same time, the combination of chronic acalculous cholecystitis and hypertension disease were aggravated by the violation of calcium exchange, which, in our opinion, can be regarded as prognostically negative tandem. The calcium content in the bile was significantly different from that in the control group, however, significant differences between the groups of patients was observed. Such incredible distinction, perhaps, can be explained in other ways the loss of calcium in hypertension. Thus, the chronic acalculous cholecystitis is accompanied by changes in calcum metabolism, which is manifested by hypocalcemia with increasing its content in the bile. The estimation of indicators based on the type of gallbladder dyskinesia. So, the greatest changes in the exchange calcum seen in patients with dyskinesia of the gallbladder on homecomin type-8,6±0,63(р <0,001). At the same time, in the process of studying the concentration of calcium in bile based on the results of sowing bile bacterial flora did not reveal any regularities, that is, the calcium content in the bile was independent of the presence or absence of the pathogen. Evaluating the indicators densitometry identified the following changes: in 80% of patients on chronic acalculous cholecystitis the observed normal density of bone tissue, 3 patients were found osteopenic changes. While in General the group of patients with normal indices of bone metabolism were detected only in 10 patients. The combination of hypertension disease and chronic acalculous cholecystitis strengthens changes in calcium metabolism, that it is possible to consider as one of mechanisms of an aggravation chronic acalculous cholecystitis at the patients with accompanying essential arterial hypertension.
Keywords: chronic acalculous cholecystitis, pathogenesis, homeostasis, calcium, hypertension disease, osteopenia
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