В работе были изучены показатели функционального состояния сосудистого эндотелия (коэффициент эндотели-альной функции, уровни эндотелина-1 и натрийуретического пептида типа С), перекисного окисления белков (карбо-нильные производные), липидов (ТБК-активные продукты), антиоксидантной защиты (супероксиддисмутаза) и воспа-ления (С-реактивный белок и фракталкин) у 35 пациентов с хронической обструктивной болезнью легких (ХОБЛ) и 50 соматически здоровых лиц Астраханского региона. У больных ХОБЛ установлено наличие дисфункции эндотелия и окислительного стресса, опосредованного перекисной деструкцией как липидных, так и белковых молекул. Констати-рована прямая корреляционная зависимость между уровнем плазменного эндотелина-1 и уровнем ТБК-активных про-дуктов, отражающая увеличение продукции вазоконстрикторов при увеличении уровня продуктов перекисного окис-ления липидов у больных ХОБЛ. Было доказано, что исследование 4а/4b полиморфизма гена eNOS имеет важное зна-чение в диагностике повреждения эндотелия при ХОБЛ.Ключевые слова: хроническая обструктивная болезнь легких, гомеостаз, эндотелиальная дисфункция, оксида-тивный стресс, воспаление, полиморфизм генов. HOMEOSTATIC DISORDERS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASEAkhmineeva A.Kh., Polunina O.S., Sevostyanova I.V. Department of Internal Diseases of Pediatric Faculty of Astrakhan State Medical University, AstrakhanThe research studied the parameters of the vascular endothelium functional state (the ratio of endothelial function, levels of endothelin-1 and natriuretic peptide of type C) of peroxide oxidation of proteins (carbonyl derivatives), of lipids (TBAactive products), of antioxidant protection (superoxide dismutase) and inflammation (C -reactive protein and fractalkine) in 35 patients with chronic obstructive pulmonary disease (COPD) and 50 somatically healthy persons of Astrakhan region. It was revealed that COPD patients had endothelial dysfunction and oxidative stress due to the peroxide destruction of both lipid and protein molecules. We stated a direct correlation between the level of plasma endothelin-1 and the level of TBA-active products reflecting an increase in production of vasoconstrictors with increasing levels of lipid peroxidation products in patients with COPD. It has been proven that the study of 4a/4b polymorphism of the eNOS gene is important in the diagnosis of endothelial damage in COPD.

Астраханский государственный медицинский университет, Россия feaTures of microVascular reacTiViTY in paTienTs WiTh Bronchial asThma comBineD WiTh arTerial hYperTension anD ischemic hearT Disease akhmineeva a. Kh., polunina o. s., sevostyanova i. V., Voronina l. p. astrakhan state medical university, russia Изучались особенности микрососудистой реактивности на ионофорез эндотелий-зависимого вазодилататора у больных бронхиальной астмой (БА) в сочетании с артериальной гипертензией (АГ), ишемической болезнью сердца (ИБС). Обследовано 35 больных БА, 35 больных АГ, 35 больных ИБС и 40 пациентов с со-Сведения об авторах:

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The objective: to compare the level of Klotho protein in patients with myocardial infarction (M I) and concurrent chronic obstructive pulmonary disease (COPD) and patients with COPD only with consideration of specific manifestations of COPD (severity of symptoms and risk of exacerbations).Subjects and Methods. 144 patients were examined and divided into the following groups: MI + COPD Group - patients with MI and concurrent COPD (60 patients), COPD Group - patients with COPD (54 patients) and HI Group - somatically healthy individuals (30 people). The patients were divided into subgroups (A, B, C, D) according to the GOLD 2019 classification. Enzyme immunoassay was used to test the level of Klotho.Results. A statistically significant lower level of Klotho was detected in patients in MI + COPD Group compared to COPD Group and healthy individuals. Patients in the subgroups with severe symptoms (B and D) in both the COPD and MI + COPD Groups had statistically significantly lower levels of Klotho compared to those in the subgroups with no symptoms (A and C). Among patients with MI + COPD in subgroups A, B, C, D, the Kloto level was statistically significantly lower versus the patients of the corresponding subgroups in COPD Group. The lowest level of Klotho was detected in MI + COPD and COPD Groups in patients of subgroup D, that was in patients with severe symptoms and frequent exacerbations of COPD. The data obtained were confirmed by correlation analysis results. It was found that in MI + COPD and COPD Groups, the level of Klotho had a negative correlation with both the severity of symptoms and number of COPD exacerbations. Correlations were the strongest between the level of Klotho and parameters characterizing the severity of COPD symptoms.