Objective. To study the clinical and laboratory features of the formation of a combination of arterial hypertension in patients with erosive and ulcerative lesions of the gastroduodenal zone and to develop a method for predicting the probability of developing this phenotype. Arterial hypertension and diseases of the gastrointestinal tract are among the common diseases, which are often observed in the same patients. Materials and methods. Employees (n = 127, males only) of locomotive crews, who work for more than 10 years at Perm-II Railway Station of Sverdlovsk Branch of OJSC Russian Railways, were examined. The methods of examination included the analysis of anamnesis data, physical, laboratory and instrumental examinations of patients. Laboratory studies included the analysis of the results of a general blood test, the serum concentration of common biochemical parameters (glucose and cholesterol), as well as the concentration of individual proteins: endothelin-1, monocyte chemotactic protein-1 and C-reactive protein. Results. The diagnostic value of determining a number of indicators for predicting the development of arterial hypertension in patients with erosive and ulcerative manifestations of the gastrointestinal tract was established. The greatest significance for the diagnosis of comorbidity was demonstrated by the level of endothelin-1, glucose and cholesterol as well as the content of white blood cells and platelets. The data obtained made it possible to develop a mathematical formula for calculating the risk of arterial hypertension in patients with erosive and ulcerative lesions of the gastroduodenal system. Conclusions. Employees of locomotive crews have an increased risk for comorbid pathology formation arterial hypertension against the background of erosive and ulcerative lesions of the gastroduodenal zone, which is accompanied by a change in a number of laboratory parameters that can be used to predict the risk of developing comorbid pathology.

A prospective comparative study of the effectiveness of rehabilitation treatment and rehabilitation of locomotive crews workers was carried out. The results of treatment were evaluated by the temporary disability of workers. As a result of regular rehabilitation treatment of locomotives’ drivers, the frequency of diseases with a temporary loss of work ability decreases by 2.7 times.

Purpose of the study. The prevalence of diseases of the gastroduodenal zone and cardiovascular pathology among the working population is alarming. In order to develop phenotypes of comorbidity of acid-dependent diseases of the gastroduodenal zone and the syndrome of arterial hypertension in hazardous workers, a study of the state of health was carried out. Materials and methods. 4 observation groups were formed, aged 40 to 60 years, with work experience of more than 10 years. The first group consisted of 51 patients with arterial hypertension, the second - 26 patients with acid-dependent diseases, the third - 25 workers with comorbid pathology. The fourth group consisted of 24 workers without this pathology. The clinical examination was carried out as part of clinical examinations in the conditions of the departmental clinical hospital of Russian Railways. To clarify the psycho-emotional status, psychometric testing was carried out using the Stilberger-Khanin anxiety scale and the SANT test. A biochemical blood test included the determination of the level of alanine aminotransferase, aspartate aminotransferase, glucose, creatinine, lipid spectrum, antibody titer to Helycobacter pylori, the amount of endothelin-1, monocytic chemoattractant protein-1. Instrumental studies: fibrogastroduodenoscopy, daily monitoring of blood pressure. Results and conclusions. Indicators of general morbidity among employees of locomotive crews are higher than those of the industry. In the structure of chronic diseases, the prevalence of isolated arterial hypertension and erosive and ulcerative lesions of the gastroduodenal zone exceeds 60%, and the calculated probability coefficient of the combination is 6 times higher than the population one. The development of comorbidity of arterial hypertension and erosive and ulcerative lesions of the gastroduodenal zone under conditions of long-term exposure to a complex of production factors in trained workers was accompanied by the prevalence of personal and situational anxiety as a reflection of the maladjustment syndrome. The main pathophysiological determining modules in each group of patients were identified: the dyscirculatory-inflammatory module was identified as a phenotype of the comorbidity of the studied pathologies. The data obtained allow us to form a personalized approach to the prevention and treatment of comorbid pathology.