Cardiomyopathies (CMP) are considered diseases with unknown etiology. CMP are usually diagnosed on the late stages of the disease. It is an important task to seek methods which allow diagnosing CMP on the early stages of development. Aim -to estimate the type of polymorphic variants of angiotensin converting enzyme (ACE), glutathione S-transferase (GSTM1) frequency distribution among the CMP sick and healthy individuals living in the Republic of Bashkortostan, and to substantiate their role in the CMP pathogenesis. Material and Methods -There were 67 CMP sick put under observation. Out of them40 werediagnosed ischemic cardiomyopathy (ICM), and 27 were diagnosed dilated cardiomyopathy (DCM). The control group was made up of 110 practically healthy people. The results.In the ICM sick group the DD genotype (χ 2 =4.8; p=0.029) was definitely found more frequently, also in case of DCM the increase of DD genotype (χ 2 =4.0, p=0.044) frequency was ascertained. Conclusion -The genetic analysis of polymorphic locus of I/D ACE gene in the ICM and DCM sick showed decrease in frequency of occurrence II, ID genotypes, I allele and increase of D genotype and D allele which points out the increased risk of these cardiovascular diseases.
Целью работы явилась оценка содержания и значения провоспалит ельных цитокинов ИЛ8, ФНОα, МСР1, противовоспалительного цитокина ИЛ10 при ХСН у больных с дилатационной и ишемической кардиомиопатией. При изучении содержания провоспалительных цитокинов, моноцитарного воспалительного белка хемокина МСР1 и провоспалительного хемокина выявлено достоверное разнонаправленное изменение уровня провоспалительных цитокинов (снижение ИЛ8, рост ФНОα) и хемокина МСР1 при дилатационной и ишемической кардиомиопатией и увеличение концентрации провоспалительного хемокина ИЛ10.
Aim. To estimate the effect of anemia of chronic diseases on the processes of cardiovascular system remodeling in patients with dilated cardiomyopathy and ischemic cardiomyopathy. Methods. The study included 27 patients with dilated cardiomyopathy with anemia, 19 with dilated cardiomyopathy without anemia, 11 with ischemic cardiomyopathy with anemia, 34 with ischemic cardiomyopathy without anemia, and 30 healthy individuals. In these comparison groups, peripheral blood, mean corpuscular hemoglobin and mean cell hemoglobin concentration, reticulocytes, serum iron and ferritin were examined. Electrocardiography, echocardiography, scintigraphy and coronary angiography were performed. Results. In all groups identical signs of chronic heart failure class 3 and 4 were found to be predominant, which was confirmed by a significant decrease of blood pressure, stroke volume, ejection fraction, increase of end systolic and diastolic volumes and sizes, as well as left and right atrial size. Patients with dilated and ischemic cardiomyopathy with anemia had decreased hemoglobin, number of erythrocytes and platelets, positive correlation between hemoglobin and serum iron (r=0.49, p=0.000), red blood cells and ferritin (r=0.61, p=0.000), negative correlation between hemoglobin and ferritin (r=-0.51, p=0.02). In ischemic cardiomyopathy with anemia positive correlation was found between hemoglobin and serum iron (r=0.54, p=0.000), erythrocytes and ferritin (r=0.49, p=0.03), negative correlation - between hemoglobin and ferritin (r=0.54, p=0.03). Conclusion. In patients with dilated and ischemic cardiomyopathy no significant effect of anemia of chronic diseases on heart remodeling processes was revealed.
пневмонические осложнения при пандемическом гриппе а/н1n1/09 ИГОРЬ ВИКТОРОВИЧ ЛЕЩЕНКО, докт. мед. наук, профессор кафедры фтизиатрии и пульмонологии ФПК и ПП ГБОУ ВПО «Уральская государственная медицинская академия» Минздравсоцразвития РФ, Екатеринбург, тел. (343) 246-44-75, e-mail: leshchenkoiv@mail.ru АЛЕКСЕЙ ВИКТОРОВИЧ КРИВОНОГОВ, врач-пульмонолог медицинского объединения «Новая больница», Екатеринбург, тел. (343) 242-48-42, (343) 246-44-75, e-mail: angedonia35@mail.ru Реферат. Изучали особенности течения и осложнения внебольничной пневмонии (ВП) при пандемическом грип-пе А/Н1N1/09 на основании клинико-лабораторных и рентгенологических данных. В исследовании участвовало 250 больных в 4 группах: 1-я группа -57 пациентов с неосложненной ВП, 2-я группа -124 больных с ВП и синдромом системной воспалительной реакции, 3-я группа -53 пациента с ВП, осложненной тяжелым сепси-сом, и 4-я группа -16 больных с ВП с септическим шоком. У 225 (90,0%) больных установлено двустороннее поражение легочной ткани. 193 (77,2%) пациента нуждались в кислородотерапии, 108 (56%) из них госпита-лизированы в отделение реанимации и интенсивной терапии, 15,6% проводилась искусственная вентиляция легких. Общая летальность составила 10,4%, среди больных с ожирением -30,0%. Ключевые слова: внебольничная пневмония, пандемический грипп А/Н1N1/09, клиника, осложнения, лечение.
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