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Abstract
Summary
The peculiarities of lipid metabolism and endothelial dysfunction in young patients with spondylogenic vertebrobasilar insufficiency
Nekrasova N.
To determine consistent patterns of changes of lipid metabolism and condition of an endothelium in patients of young age with the spondylogenic vertebrobasilar insufficiency we examined 98 patients (women - 56, men - 42) with manifestations of SVBI on the background of neurovascular and radicular syndromes of osteochondrosis of cervical vertebral column. Patients, age 18 to 40 years (middle age of 28.5±3.8 years) were included in this study. All study subjects underwent functional X-ray examination, cervical spine MRI and duplex scanning of neck vessels for verification diagnosis. The dynamics of blood flow indices in suboccipital (VA3) segments of vertebral and basilar arteries (BA) by dopplerography were calculated.
The received data of correlation analysis confirmed the assumption of interrelation between lipid metabolism and state of an endothelium in patients with SVBI, having revealed positive correlation between the TCh level and endothelin-1 level (r = + 0.58; p ≤0.05), with the same index in control group (r = + 0.28; p ≤0.05). The negative correlation dependence between S-NO and LDL (r = - 0.1, p≤0.05) in patient’s group was detected, in control group – (r = - 0.02, p ≤0.05). Revealed in the examined patients reliable (p ≤0.05) positive correlation between the LDL level and TCh (r = +0.89) against positive correlation between the HDL level and TCh (r = +0.52) shows the sanogenetical activation of reserves in the young contingent patients and strengthening of development of an anti-atherogenous reserve. The received correlation showed that lipid metabolism plays a significant role in the promotion of endothelium dysfunction.
Key words: lipid metabolism, endothelial dysfunction, spondylogenic vertebra-basilar insufficiency
Резюме
ОСОБЛИВОСТІ ЛІПІДНОГО МЕТАБОЛІЗМУ ТА ЕНДОТЕЛІАЛЬНА ДИСФУНКЦІЯ У ОСІБ МОЛОДОГО ВІКУ ІЗ СПОНДИЛОГЕННОЮ ВЕРТЕБРО- БАЗИЛЯРНОЮ НЕДОСТАТНІСТЮ
Некрасова Н.О.
З метою дослідження стану ліпідного обміну та функції ендотелію у пацієнтів молодого віку зі спондилогенною вертебрально -базилярною недостатністю обстежено 98 пацієнтів (жінок - 56, чоловіків - 42) з проявами вертебрально - базилярної недостатності на тлі м'язово - рефлекторних, нейросудинних і корінцевих синдромів остеохондрозу шийного відділу хребта. У дослідження були включені хворі від 18 до 40 років (середній вік 28,5 ± 3,8 років). Всім пацієнтам проводилася функціональна рентгенографія шийного відділу хребта зі згинанням і розгинанням, МРТ шийного відділу хребта, а також ультразвукове доплерографічне дослідження судин шиї і магістральних артерій голови (УЗДГ) із застосуванням функціональних навантажень з ротацією голови, а також дуплексне сканування судин шиї.
В результаті проведеного дослідження було виявлено, що спондилогенна вертебро-базилярна недостатність супроводжується порушенням обміну ліпідів, що характеризується різноспрямованими змінами рівня загального холестерину, тригліцеридів , ліпопротеїдів низької щільності, ліпопротеїдів дуже низької щільності і ліпопротеїдів високої щільності, що свідчить про зсуви плазмових показників ліпідтранспортной системи у бік атерогенезу. Ендотеліальна дисфункція у даного контінтента хворих характеризується збільшенням концентрації ендотеліну- 1, який є вазоконстикторним фактором на тлі зменшення активного метаболіту оксиду азоту - S- NO, якому притаманні вазодилатуючі властивості.
Ключові слова: ліпідний метаболізм, ендотеліальна дисфункція, вертебро-базилярна недостатність
Резюме
ОСОБЕННОСТИ ЛИПИДНОГО МЕТАБОЛИЗМА И ЭНДОТЕЛЬНАЯ ДИСФУНКЦИЯ У ЛИЦ МОЛОДОГО ВОЗРАСТА СО СПОНДИЛОГЕННОЙ ВЕРТЕБРО-БАЗИЛЯРНОЙ НЕДОСТАТОЧНОСТЬЮ
Некрасова Н.А.
C целью исследования состояния липидного обмена и функции эндотелия у пациентов молодого возраста со спондилогенной вертебрально-базилярной недостаточностью обследовано 98 пациентов (женщин - 56, мужчин - 42) с проявлениями вертебрально-базилярной недостаточности на фоне мышечно-рефлекторных, нейрососудистых и корешковых синдромов остеохондроза шейного отдела позвоночника. В исследование были включены больные от 18 до 40 лет (средний возраст 28,5±3,8 лет). Всем пациентам проводилась функциональная рентгенография шейного отдела позвоночника со сгибанием и разгибанием, МРТ шейного отдела позвоночника, а также ультразвуковое допплерографическое исследование сосудов шеи и магистральных артерий головы (УЗДГ) с применением функциональных нагрузок с ротацией головы, а также дуплексное сканирование сосудов шеи. Показатели липидного обмена в сыворотке крови определяли спектрофотометрическим методом, концентрацию эндотелина-1 в сыворотке крови - методом иммуноферментного анализа, cодержание S-NO - спектрофлюориметрическим методом.
В результате проведеного исследования было выявлено, что спондилогенная вертебрально-базилярная недостаточность сопровождается нарушением обмена липидов, характеризующимся разнонаправленными сдвигами уровня холестерина, липопротеидов низкой плотности, липопротеидов очень низкой плотности и липопротеидов высокой плотности, свидетельствующем о сдвиге плазменных показателей липидтранспортной системы в сторону атерогенеза. Эндотелиальная дисфункция у данного континтента больных характеризуется увеличением концентрации эндотелина-1, являющегося вазоконстикторным фактором на фоне уменьшения активного метаболита оксида азота - S-NO, обладающего вазодилатирующими свойствами.
Ключевые слова: липидный метаболизм, эндотелиальная дисфункция, вертебро-базилярная недостаточность
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