[Cardiovascular risk factors in patients with ulcerative colitis]

BACKGROUND

Given the current trends in increasing the life expectancy of patients with ulcerative colitis (UC), the study of the risk of atherothrombotic events in them requires study. For effective prevention of cardiovascular diseases, it is necessary to assess cardiovascular risk factors since the concept of their timely detection is the basic one when planning preventive measures.

AIM

To assess the prevalence of cardiovascular risk factors in patients with UC.

MATERIALS AND METHODS

One hundred eighty four UC patients participated in the case-control study; 56 participants were included in the control group. The studied parameters are unmodified, behavioral, and biological factors of cardiovascular risk. The study participants were surveyed, examined, measured blood pressure, height, weight, the level of total cholesterol was studied, and the lipid spectrum was analyzed in 80 patients with UC. Parametric and nonparametric statistical methods were used.

RESULTS

UC patients consumed fruit less often, drank tea and coffee with sugar more often, exercised less often and experienced high levels of stress. A higher incidence of arterial hypertension in UC patients was established, even though the fact of taking glucocorticosteroids was considered. No significant differences were found in the assessment of relative and total cardiovascular risk.

CONCLUSION

Risk management of cardiovascular diseases in UC patients should focus on a personalized approach and timely screening of modifiable cardiovascular risk factors with their subsequent correction. The absence of significant differences in the level of relative and total cardiovascular risk indicates a limited contribution of traditional risk factors to the development of cardiovascular diseases in UC patients.

[Influence of phosphogliv® hepatoprotector on phospholipid spectrum of peripheral blood mononuclears in patients with tuberculosis of lungs.]

The administration of the "Phosphogliv®" hepatoprotector in the comprehensive treatment of patients with pulmonary tuberculosis will allow determining its effect on the lipid composition of membranes of mononuclear cells under conditions of etiotropic chemotherapy according to 1 standard regimen. The determination of the ratios of the most important classes of phospholipids in membranes of peripheral blood mononuclear cells will give an idea of the structural-functional state violation of the most important representatives of the cellular immunity in patients with tuberculosis prior to treatment, against the backdrop of the intensive phase of the main course of chemotherapy as well as the change in these indices when the "Phosphogliv®" drug is administered in the comprehensive treatment therapy. The study included 356 patients with pulmonary tuberculosis of young and middle age, out of which 308 patients received etiotropic chemotherapy without the administration of phosphogliv, and 48 patients receiving comprehensive treatment used a combined scheme of oral-parenteral administration of phosphogliv. The administration of the "Phosphogliv®" hepatoprotector in the comprehensive treatment of tuberculosis patients made it possible to reduce the severity of the toxic effect of anti-tuberculosis drugs on peripheral blood mononuclear cells, to reduce the degree of disorganization of their membranes and to bring the phospholipid spectrum closer to the corresponding values of the control group. Direct positive clinical and radiological dynamics in 81.5% of patients in the second group and 87.5% in the third group was noted during the analysis of laboratory data and the X-ray pattern. After 2 months of the intensive phase of anti-tuberculosis chemotherapy, abacilation was achieved in 61% of patients having no phosphogliv administered, and in 81% of patients receiving complex therapy with the administration of "Phosphogliv®" hapatoprotector. More apparent positive X-ray dynamics (infiltration zone and dissemination foci decrease) was observed in patients receiving Phosphogliv®.

[Prospective analysis of lipid profile parameters and markers of vascular inflammatory response with prognosis of undesirable coronary events in patients with coronary heart disease after angioplasty with stenting.]

The study of the causes of the development of vascular coronary complications after angioplasty with stenting using the evaluation of biochemical parameters in the dynamic observation of patients with IHD with significant coronary stenosis determines the relevance of the study. To analyze the parameters of lipid spectrum and markers of vascular inflammatory reaction in patients with IHD, in groups with stable angina and episode of unstable angina after angioplasty with stenting, to trace the dynamics of biochemical parameters and to reveal the predictors of undesirable coronary events. Patients with IHD with significant coronary stenosis of the arteries (SCS, n = 95) after coronary angiography at the point of maximum increase in the level of markers of the inflammatory reaction (3 months after angioplasty) are divided into 2 groups - patients with persistent stable angina pectoris (SA, n = 77) until the end of the study and patients with developed postvascularization episode of unstable angina (UA, n = 18). The dynamics of observation of biochemical parameters recorded the absence of normalization of the atherogenic spectrum of the lipid profile and the prolonged nature of the vascular inflammatory response to the end point of observation after angioplasty.The method of binary logistic regression revealed that in the general group of patients with IHD, an increase in the level of low density lipoprotein cholesterol by 1 mmol / L significantly increases the probability of significant coronary stenosis in men and raises the risk of UA after angioplasty by 7.38 times. It was found that patients with UA at the initial stage have a significantly higher risk of coronary blood flow instability in the post-vascularization period due to an elevated level of homocysteine. A set of biochemical markers for predicting the significance of coronary stenosis and development of undesirable vascular coronary events after angioplasty in patients with IHD has been identified: male sex, elevated LDL cholesterol and hyperhomocysteinemia.

[Indicators of lipid exchange as early markers of development calcific aortic valve disease.]

A comprehensive study of lipidograms of 36 patients with initial signs of calcification of aortic semilunium was performed. It was determined that the content of apolipoprotein A-1 was significantly lower in comparison with the control groups, which requires further studies of the evaluation of the effect on the process of early development of calcification of drugs capable to increasing its content. If the concentration of apolipoprotein A-1 is less than 1,1 mg/dl and/or the apoB/apoA ratio is increased by more than 1, it is advisable to recommend dispensary follow-up with regular (no less than 1 time in 5 years) echocardiographic study with a detailed study of the functional state of the aortic valve.

[Impact of impaired carbohydrate metabolism on the course of coronary heart disease]

In patients with coronary heart disease (CHD) and periodically recorded impaired fasting glycemia, the Incidence of impaired glucose tolerance and type 2 diabetes mellitus was 61.6 and 17.8%, respectively. CHD patients with a history of carbohydrate metabolic disturbance were observed to have hyperinsulinemia on fasting and 2 hours after glucose load. In these patients, ambiguous changes were found in C-peptide 2 hours following glucose load. Changes were ascertained in the lipid spectrum.