Экспрессия некоторых СС- и СХС-хемокинов и их рецепторов у больных ишемической болезнью сердца тема диссертации и автореферата по ВАК РФ 14.01.05, кандидат медицинских наук Нильк, Ростислав Ярославович

• Нильк, Ростислав Ярославович
• кандидат медицинских наук
• 2011

Оглавление диссертации кандидат медицинских наук Нильк, Ростислав Ярославович

Список сокращений.

Введение.

Глава 1. Обзор литературы.

1.1. Система хемокинов и хемокиновых рецепторов и ее участие в воспалительном процессе.

1.2. Современные представления об иммунопатогенезе атеросклероза.

1.3. Влияние препаратов для лечения ишемической болезни сердца на процессы воспаления.

1.4. Применение со-3-полиненасыщенных жирных кислот у больных ишемической болезнью сердца.

Глава 2. Материалы и методы исследования.

2.1. Общая характеристика обследованных пациентов.

2.1.1. Характеристика пациентов, получающих терапию со-3 полиненасыщенными жирными кислотами.

2.2. Методы исследования.

2.2.1. Методика определения липидного спектра сыворотки крови.

2.2.2. Методика выделения РНК из тканей.

2.2.3. Методика выделения РНК из периферической крови.

2.2.4. Определение мРНК хемокинов и хемокиновых рецепторов методом ЫТ-РСЯ.

2.2.5. Методика проведения холтеровского мониторирования электрокардиограммы.

2.2.6. Методика выполнения эхокардиографического исследования сердца.

2.3. Статистическая обработка.

Глава 3. Показатели экспрессии хемокинов и их рецепторов у больных ишемической болезнью сердца.

3.1. Показатели экспрессии хемокинов и их рецепторов в периферической крови больных ишемической болезнью сердца.

3.2. Показатели экспрессии хемокинов и их рецепторов в тканях аорты.

3.3. Показатели экспрессии хемокинов и их рецепторов в тканях внутренней грудной артерии.

3.4. Показатели экспрессии хемокинов и их рецепторов в тканях лучевой артерии.

3.5. Показатели экспрессии хемокинов и их рецепторов в тканях поверхностной вены бедра.

Глава 4. Клинические эффекты со-3 полиненасыщенных жирных кислот у больных ишемической болезнью сердца при коронарном шунтировании.

Глава 5. Влияние со-3 полиненасыщенных жирных кислот на синтез хемокинов и хемокиновых рецепторов у больных ишемической болезнью сердца.

5.1. Влияние со-3 полиненасыщенных жирных кислот на синтез хемокинов и их рецепторов в периферической крови пациентов с ишемической болезнью сердца.

5.2. Влияние со-3 полиненасыщенных жирных кислот на синтез хемокинов и их рецепторов в тканях аорты у пациентов с ишемической болезнью сердца.

5.3. Влияние со-З полиненасыщенных жирных кислот на синтез хемокинов и их рецепторов во внутренней грудной артерии у пациентов с ишемической болезнью сердца.

5.4. Влияние со-З полиненасыщенных жирных кислот на синтез хемокинов и их рецепторов в лучевой артерии у пациентов с ишемической болезнью сердца.

5.5. Влияние со-З полиненасыщенных жирных кислот на синтез хемокинов и их рецепторов в тканях большой подкожной вены у пациентов с ишемической болезнью сердца.

Глава 6. Обсуждение.

Выводы.

Заключение диссертации по теме «Кардиология», Нильк, Ростислав Ярославович

113 Выводы

1. Показатели экспрессии мРНК хемокинов эотаксин, эотаксин-2, 1Ь-8, М1Р-1а, МПМр, КАЫТЕБ, а также мРНК хемокиновых рецепторов: ССЮ, ССЮ, СС115, СХСЮ, СХСЮ. в периферической крови у больных ишемической болезнью сердца снижены по сравнению со здоровыми лицами.

2. Экспрессия мРНК хемокинового рецептора ССЮ и хемокина М1Р-1а в периферической крови, а также экспрессия мРНК хемокина М1Р-1р в тканях поверхностной вены бедра у больных ишемической болезнью сердца ассоциирована с длительностью заболевания; экспрессия мРНК хемокина М1Р-1р и хемокиновых рецепторов СХСЮ, СХСК2 в тканях внутренней грудной артерии и аорты, а также экспрессия мРНК хемокиновых рецепторов ССЮ и ССЫЗ в тканях аорты - с уровнем общего холестерина; экспрессия мРНК хемокиновых рецепторов ССЮ, ССЮ, ССЯ5, СХСЮ, СХСЯ2 в тканях внутренней грудной артерии, мРНК хемокинового рецептора СХСЮ в периферической крови, в тканях аорты ассоциирована с фракцией выброса левого желудочка.

3. Дополнительное назначение к стандартной терапии ишемической болезни сердца со-3 ПНЖК в дозе 2,0 г/сут в течение 14 дней приводит к восстановлению исходно сниженной экспрессии мРНК хемокиновых рецепторов ССЮ, ССЮ, СС115 в плазме крови.

4. У больных ишемической болезнью сердца со-3 ПНЖК в дозе 2,0 г/сут в течение 14 дней приводит к увеличению экспрессии мРНК хемокиновых рецепторов ССЮ, ССЮ, СС115 в аорте и большой подкожной вене, внутренней грудной артерии.

5. Применение со-3 ПНЖК в дозе 2,0 г/сут в течение 14 дней до коронарного шунтирования и в раннем послеоперационном периоде сопровождается снижением частоты развития послеоперационной фибрилляции предсердий и меньшей выраженностью гемодинамических нарушений.

Практические рекомендации

Для снижения риска развития фибрилляции предсердий после коронарного шунтирования у больных ишемической болезнью сердца рекомендуется прием со-3 ПНЖК в дозе 2,0 г в сутки в течение 14 дней перед операцией и в раннем послеоперационном периоде.

Следует воздерживаться от приема препаратов ю-З-ПНЖК в раннем периоде после коронарного шунтирования у больных, получающих терапию непрямыми антикоагулянтами.

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