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, ,
,
MOSCOW INTERNATIONAL FORUM OF CARDIOLOGY
2628 2013 , . 26-28 March 2013, Moscow
ACCEPTED ABSTRACTS
, 2013; 12 ()CARDIOVASCULAR THERAPY AND PREVENTION 2013; 12
(March), special edition
:
:
:
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, 2013; 12 () 3
001-005
001 HAWTHORNE IN INCREASING CARDIO STRENGTH
Gabinskiy V., von Peters W., Kushnir I., Gabinskaya L.,
Gabinskaya I., Gabinskiy R., Gorinshteyn B.
First National University, Idaho, Russian-American University,
Atlanta, USA
The herb Hawthorne (Crataegus oxycantha) has been used as a
heart tonic for centuries. Hawthorne is a spiny shrub that has been
traditionally used as a heart tonic in European herbal medicine.
The herb is a rich source of bioflavonoids and anthocyanidins. The
herbal medicine is made from an extract of the leaves or berries
blossoms of two primary species (Crataegus oxycantha and Crataegus
monogyna).
In this study 17 males age 4768 who satisfied entry criteria of
confirmed Cardio-Vascular Disease (CVD) disease with at least 60%
blockage as determined by Echocardiogram were placed on the
protocol for 120 days.
Therapeutic dosages for the Hawthorne was 250 mg. per day in
capsules divided into two doses. Hawthorne group achieved a mean
increase of 22% in coronary blood flow plus improvement.
Participants also reported increased stamina, better wind, and
the ability to participate in everyday activities without
breathlessness.
Our conclusion is that hawthorne berry should be considered as
an adjunct to standard cardiotherapy.
002 GREEN COFFEE EXTRACT IN IMPROVING HUMAN VASOREACTIVITY
Gabinskiy V., von Peters W., Kushnir I., Gabinskaya L.,
Gabinskaya I., Gabinskiy R., Gorinshteyn B.
First National University, Idaho, Russian-American University,
Atlanta, USA
Green coffee bean extract is made from the green beans of the
coffee Arabica plant. There are two types of coffee plants, arabica
and robusta the arabica is higher in quality and higher in
chlorogenic and coffee acids, two primary compounds responsible for
anti-oxidant activity.
The extract has strong anti-oxidant properties similar to other
natural anti-oxidants like green tea and grape seed extract. These
beans have polyphenols which act to help reduce free oxygen
radicals in the body (in other words acting as good antioxidants).
Green coffee bean extract is standardized to 30 to 50% chlorogenic
acid, a compound present in coffee which has long been known for
its beneficial properties.
It has been found that the extract contains significant amounts
of chlorogenic acid, ferulic acid that acts on nitric oxide derived
from the vascular endothelium.
The study involved 15 generally healthy males between the ages
of 37 and 64, who were diagnosed with reduced vasodilatation
responses, as measured by strain gauge plethysmograms (SPG) to
ischemic reactive hyperemia. The SPG was taken before and after the
90 day ingestion period.
The reactive hyperemia ratio (RHR) increased 12% in the final
SPG. In addition, there was a significant decrease in the plasma
total homocysteine level compared with the pre-ingestion level.
Further, without changing dietary or exercise habits the study
participants lost an average of 10.5% of their overall body weight
and 16% of their overall body fat.
It should be noted that roasted coffee beans do not contain the
chlorogenic acid, and thus drinking coffee does not have the
benefit of green coffee bean extract.
Conclusion: Green coffee bean extract can be a valuable adjunct
both in increasing vasoreactivity and in helping reduce cardiac
risk factors such as obesity.
003 STAPHISAGRIA AND POST-SURGICAL COMPLICATIONS
Gabinskiy V., von Peters W., Kushnir I., Gabinskaya L.,
Gabinskaya I., Gabinskiy R., Gorinshteyn B.
First National University, Idaho, Russian-American University,
Atlanta, USA
Staphisagria is an herb that is traditionally used as a
vermifuge, emetic, cathartic, and narcotic. However, it is when
prepared in homeopathic potency that its usage in surgery, both
pre- and post-surgical, gains its efficacy.
Homeopathic Staphisagria is regarded as the best remedy in the
homeopathic armamentarium for use with incised wounds, i. e., where
there is a clean cut, such as after surgery. Used here the remedy
helps prevent post-operative pain, and promotes an intensified
healing.
In our study 13 people were given Staphisagria in the 30C
potency post cardiac bypass surgery. The Staphisagria was taken 6
pellets prior to surgery, and then every 4 hours post surgery for
the first two days following the surgery, and thereafter 3 times
daily for 2 weeks. Staphisagria 30C was used along with standard
medical treatment for pain and post surgery.
The results were that the participants reported, on average,
less pain and a faster healing of the incision site, and less
problems with sutures was noted. The surgical site overall had less
swelling and complications. Healing time, on average was about 30%
faster than normally found without usage of Staphisagria 30C.
Staphisagria has been a part of the homeopathic armamentarium
for well over 100 years. In potency, such as this study, it is a
safe and valuable adjunct to standard medical post-operative
care.
004 EFFECT OF NARCOTIC TREATMENT ON OUTCOMES OF ACUTE CORONARY
SYNDROMES
Iakobishvili Z., Porter A., Battler A., Behar S., Roth A., Atar
Sh., Boyko V., Mager A., Hasdai D.
Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
Background: Current guidelines have recommended intravenous
narcotics (IVNs) for patients with ST-segment-elevation acute
coronary syndromes (STEACS) and patients with non-STEACS (NSTEACS),
although the safety of IVNs has been challenged.
Methods and results: We performed a retrospective analysis of
the 30-day outcomes stratified by IVN use among patients enrolled
in a national survey, using logistic regression and propensity
score analysis. Of the 765 patients with STEACS and 993 patients
with NSTEACS, 261 (34.1%) and 97 (9.8%) had received IVNs,
respectively. The patients with STEACS who received IVNs were more
likely to undergo reperfusion (79.7% vs 55.2%, p
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, 2013; 12 ()4
006-007
Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of
Medicine, Tel Aviv University, Tel Aviv, Israel
Background: We aimed to determine the optimal renal function
formulas for risk stratification in acute decompensated heart
failure (ADHF) and chronic heart failure (CHF).
Methods: We compared 5 formulas of estimated glomerular
filtration rate (eGFR) for prediction of 30-day, 1-year, and 4-year
mortality in a nation-wide heart-failure survey: chronic kidney
disease epidemiology collaboration (CKD- EPI), modification of diet
in renal disease (MDRD), Mayo quadratic (Mayo), inulin clearance
based (IB), and Cockcroft-Gault (CG (.
Results: Of the enrolled patients, 1604 ADHF and 1100 CHF
patients had 1 measurement of serum creatinine. Renal insufficiency
(RI), defined as eGFR
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, 2013; 12 () 5
008-010
52% of the surveyed persons, i. e. variant presence 677
(genotypes / or /) were observed in 6272% of cases. Almost similar
results have been received in our research (77, 7%) that allows to
carry us in group of the European samples of the population with
polymorphism on a mutation 677 gene MTHFR.
Thus, carrying out of genetic identification of Ala222Val of
gene MTHFR for the purpose of revealing of group of individual RF
will allow optimizing in due time primary and secondary preventive
maintenance of an atherosclerosis and atherothrombosis at the
population that substantially will lower SAE case rate.
008 ROLE AND INFLUENCE OF THE COAGULATIVE FACTOR OF POLYMORPHISM
OF GENES ON THE CURRENT OF THE ISCHEMIC HEART DISEASE AT PERSONS OF
UZBEK NATIONALITY
Nurillayeva N. M.Tashkent Medical Academy, Tashkent,
Uzbekistan
Considering multifactorial character of an ischemic heart
disease (IHD) pathogenesis, i. e. presence of set of the risk
factors leading to development and advance of disease, analysis
carrying out on presence of associations of polymorphism Ala222Val
of a methylene tetra hydro folate reductase gene (MTHFR) with the
clinical-anamnesis data of ischemic heart disease patients in
investigated groups became a research objective. 2 groups of the
patients suffering an ischemic heart disease became the material of
the research, in I group 68 patients werent trained at the health
School, the second comparable 67 patients, were trained in the
conditions of School of health of a primary link of public health
services.
The burdened anamnesis on disease in I group (i. e. presence of
an ischemic heart disease at parents and close relatives) at 45
(66,2%) the patients, not burdened at 18 (26,5%) is taped, at 5
(7,3%) patients predisposition to an ischemic heart disease at
parents didnt become perceptible. According to the anamnesis data
of patients of II group hereditary burdeness is defined at 43
(64,2%) ischemic heart disease patients, 24 (35,8%) the patient of
predisposition to disease havent noted the others. Frequency of
occurrence of heterozygotic genotype Ala222Val of gene MTHFR has
appeared above almost on 42% in group of ischemic heart disease
patients concerning group of healthy faces. For today it is already
known that the risk of development of a serious stenocardia is
directly proportional to quantity of the found out genetic
deviations. The given hypothesis is confirmed with presence at our
patients of a clinical debut of an ischemic heart disease, i. e.
positive correlation communication r=0,20 is found out. Besides it,
at ischemic heart disease patients of persons with heterozygotic
genotype MTHFR notes presence of high occurrence of controlled risk
factors: a disturbing-depressive syndrome in 59,8%; obesity in
56,3%; hypercholesterolemia in 36,2% of cases, and also directly
proportional dependence of genetic deviations with high frequency
of hospitalization (1,6 times a year) and higher functional class
of a stenocardia (III and IV) in 61,3% of cases. Considering high
frequency of occurrence of a mutation of gene MTHFR among
coagulative factors and its communication with modified risk
factors of an ischemic heart disease, carrying out of the further
genetic researches for active primary and secondary preventive
maintenance of stable angina of exertion as diagnostic criterion of
an early manifestation and ischemic heart disease advance is
necessary. Studying of association of polymorphisms of the
specified genes with development and a current of the above-stated
pathology in the presence of certain modified RF, also will allow
to estimate risk of development of conditions menacing to life, and
also correctly to define ways of their treatment, preventive
maintenance and possibility of application of those or other
medicinal preparations.
009 PHYSICAL ACTIVITY IN MEDICAL STUDENTS WITH PREHYPERTENSION:
HOW DOES IT WORK?
Venevtseva Y., Liashenko K., Gomova T., Melnikov A., Borisova
O.
Tula State University, Tula, Russia
Purpose. Mental overload in the medical school may lead to
maladaptation and casual blood pressure (BP) rise. It seems to be
due of insufficient physiological reserve. Modern environment does
not need any physical exertion in the day life, but optimal
physical activity may have beneficial effect on health and
performance.
The aim of the study was to evaluate the influence of 12-week
program of aerobic fitness (45 min. twice weekly, treadmill, mean
heart rate (HR) in the steady state phase 130 beats/min, with
10-min. relaxation) on the functional status in 28 university
students (6 male, 22 female) aged 1920 yrs with low habitual
physical activity level and high normal BP.
Methods. HR and BP at the rest and during exercise were measured
before, after 6 week (w) and in the end of intervention. The
autonomic tone and regulation has been evaluated with 5-min. ECG
recording in supine and standing position. Heart rate variability
(HRV) was calculated in the time (SDNN, RMSSD) and frequency
domains (total spectral power, TP, power in VLF, LF and HF band).
The battery of psychometric tests was used to access executive
(active attention, working visual memory) and sensorimotor function
(simple reaction time, choice reaction time, flicker fusion rate,
finger tapping test and motor coordination).
Results. After 12-w training HR (87.1 vs 80.0 beats/min),
systolic BP (M+/-SD) before 132.54.2 mm Hg, 119.09.1 mm Hg after 6
w and 115.95.8 mm Hg in the end, P
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, 2013; 12 ()6
011-012
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, 2013; 12 () 7
013-014
. , III : 62,384,12% - II : 64,964,29% (
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-
, 2013; 12 () 9
018-019
STATISTICA-6,0. - - , - -. , , 3 6 .
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, 2013; 12 ()10
020-021
(). 2 2 - () (6,390,17 . 5,310,07 ., =0,0001), -- () (4,770,17 .
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, 2013; 12 () 11
022-024
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-
, 2013; 12 ()12
025-027
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-
, 2013; 12 () 13
028-030
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-
, 2013; 12 ()14
031-032
19,138). - (8,9% - 2,6%, =0,108, 3,652, 9% 0,94414,125). (11,6%
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=0,006). ( +) (41,9% 23,9%, =0,028, - 2,28, 95% 1,153,27%), (44,4%
23,9%, =0,006, 2,54, 95% 1,354,79%). , . (5 T>C) I. - - (19,8%
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-
, 2013; 12 () 15
033-035
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-
, 2013; 12 ()16
036-037
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-
, 2013; 12 () 17
038-040
038 5,10- - 2
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: 677 () 2 .
: 62 2 (1 ) ( 53,75,5 ), 47 2 () (2 ) ( 52,24,7 ). - 89 45 60 -
. - . -. - . - IMMULITE 2000 Homocysteine (AXSIS). - Markett
Hellige HELLIGE CardioSoft V3.0.
: 2 - 677 677 2 . 2 677 (=4,72, p=0,029) 677 (=4,72, p=0,029)
677 (=5,24, p=0,022), . 677 (OR=1,879, C.I. [1,0593,333], =4,72,
=0,029) 2 . - , (22,90,51 umol/l, 150,7 umol/l 10,4+1,0 umol/l
,
-
, 2013; 12 ()18
041-042
, / () , 2- - () /, . -. 1- - , 2- 72- .
. 24% (22 91) , 55% (12 22) 1 , 45% (10 22) . 22 14% (3 22) - ,
- 2 3, 1 (5%) . , CHADS2 CHA2DS2-VASc: 2 18% (16 91), 3 19% (17
91), 4 24% (22 91), 5 23% (21 91), 6 4% (4 91) 7 3% (3 91).
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-
, 2013; 12 () 19
043-045
(5,2 7 ), 2,870,05 2,320,06 , - 5,2; 7; 7 5,3 , (p
-
, 2013; 12 ()20
046-047
. () - .
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LF , VLF , ULF - . - , F (ULF, VLF, LF, HF) - () : - F,% (ULF, VLF,
LF, HF) = F (ULF, VLF, LF, HF) / TP 100%. STATISTIKA 6.0 Windows
(StatSoft Inc, ). - (r).
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-
, 2013; 12 () 21
048-049
36 .; . 1.3. 11 .
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I-18, . 1.3. . VI-18. , . Q S - - . 1.1. . VI-17, . 1.2. . I-17, .
1.3. . I-18. S ( ) Q ( ) rs qr. , - -, (), - . . Q ( ) S ( ) qr rs.
- qrs rsr , rsr - - ( r) - . 1.2. - rsr (- - ). max - sum maxR
(ri>rd) + S / sum R + maxQ (qd>ql) sum maxS (qsd2SD max VI-9
. q (3 ). S DA=8,25. DA2SD, 4 max II-10 3,39, q . DA2SD (19 ) - . S
DA2SD= 55,13. . , , , . .
. QRS . - - DI.
049
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64 ( 61,957,54 , 45, 19), - . - ( , 12 ) - ( ST ). , - , - - -
HADS .
, (34,4%) . - (85,9% ), 5 . (32,8%)
-
, 2013; 12 ()22
050-052
2 ( 5 ). , 71,9% - ( 32,03,84 / 2). - , 2/3 - . ( ) 28,6% .
, (48,4%) - , . 1,520,58. 14,2% .
, - , , 2 , - . , -.
- , , - . , - .
050
. ., . ., . . ,
,
. , .
. 45 4 - ( - ) : , , , . 3 : 1- (20 ), 2- (13), 3- (12).
. - 31% , , , 12% 2 3 . 44% , , 56%. , - 2- (57 50% -), . ( 35
50%) , , ( 8% - ). 3 ( 40 50% ), 36% 38% .
. - 2845% , . ( . .,2009), - . - ,
- .
051 , ,
. ., . ., . ., . ..
. . . , ,
. .
. 88 , . - . 1 - () (n=38). 2 - - (n=50). - - ( - - :0.1, 1 5
).
. 16 : rs10306114, rs3842788, rs2282169, rs10306143, rs5277,
rs5275, rs12248560, rs28399504, rs4986893, rs4244285, rs56337013,
rs1057910, rs2242480, rs2046934, rs10935838, rs10445642 - .
CYP2C19*2 (2=8,08, p
-
, 2013; 12 () 23
053-054
() , - - , . - . , - . - () .
: 1 2 - , () () 1 2 .
- 2009 . - , , ( 39722005).
141 ( 46,47,9 ) 1 (32 ) 2 (109 ), 108 33 , - (). I 66 ( 1 20 , 2
46). II 52 1 ( 1 9 , 2 43). III 23 2 ( 1 3 , 2 20).
() . ( (), - , , - ) (I 69%, II 73%, III 78%).
. I - 7,5%, II 8,4%, III 13%. - I 4,5%, II 1,92%, III 8,68%.
, -, 9 I (13,5%), 3 II (5,76%) 3 III (13%). , - 22 I (33%), 14
II (26,9%), 3 III (13%).
I 4 (6%), II 10 (19,2%), III 6 (26%). , 2 (
-
, 2013; 12 ()24
055-056
, ; ; ; ; ; ; ; ; -; ; ; ; ; ; ; ; ; ; ; ; ( ). - t- , 2 ( -
).
. -, (=5,85; =0,013) - . : ( =8,67; = 0,0084).
. , - : (=0,035), (=0,036), III (=0,0001), (=0,02), - (=0,006).
, (=0,014) , .
- - (=7,57; =0,005). , - (=13,4; =0,0002). - . 18,79,7% . -
(48,16,8%). - -: =4,34 ( 0,033) (0,05).
, , , (=0,0051).
. - : , , - , , , , , , , . : , , .
055
. ., . ., . . ,
,
. - () (), - () ().
. 90 - . -.
. 3 . (n=34) , 15 . (n=30) - (+). 8 . (n=30) . 5 /. - HAQ DAS28.
Sharp G. C. - .
. () 1- . () . - - (=0,52,
-
, 2013; 12 () 25
057-058
(). 25,5% - : - (20,0%) (5,5%) . () 89,7% -, (+) 37,9% . - 97,2%
, 64,2%. . 2,1% - (- - , - ). , - , - , ST (OR=0,30, 95% CI
[0,140,63], p=0,004). 75150 (84,0%), 10,2% - 50 , 5,8% >150 .
100% - 75 .
: , . - (+) .
057 - , :
. ., . . ,
,
: , (), - - () .
: 20102012 . 3 (, , ) ( ). ( ) , 6 .
: 1068 . 63,610,2 , 61,2% . ST ( ST) 53,2%, ST ( ST) 41,1%, 5,7%
(). - () 89,7% , (+) - 37,9% . - (-) 87,8% . - (70,1%), (22,5%)
(7,4%). - () 70,8% -. (36,9%), (33,3%), (15,1%), (10,3%), (2,2%)
(2,1%). 70,3% . - (49,7%) (47,8%), 2,5% - . - (47,8%) (-, , )
42,0%. - :
II (12,5%), (25,5%), - (21,7%), (2,1%). , ( ST), - (=0,44, 95%
[0,230,86], p=0,008), II (=0,49, 95% [0,270,92], p=0,02).
: , , . - , - -, : (, ), -, , .
058
. ., . ., . ., . . -
, , - , , ,
() () - - , .
: - 1 600 ( ) 0,4 2 .
: 45 45 65 . . 710 , 2 . 8 (), . - (). 10% - 30% .
-
, 2013; 12 ()26
059-061
. - - , -. - , .
. - . , .
059 3 ,
. ., . ., . ., . . -
, , , ,
: ( 3- ) - , .
. 35 , 1 3 . 35 , 59,5 . - 10%, 35%, , . - , - . - ( 85% ), (45%
, 30% ), - (35% 28% ), - () 18%. 20 , , . - 1,0 46 .
. - . 12% -, 21%. - ( 14%, 27%). - ( -). - - - - . - . 8% -, - .
. - , - - .
. , , - -, .
060
. . 1, . . 21 -
, , ; 2 , ,
, - -, - . , , , -.
: - - -.
: 30 - 50 75 - . (46,1%) 5 , 4- . , - () - () ; - () - , () . ()
- . .
86% . 0,550,03 0,70,04 (
-
, 2013; 12 () 27
062-064
: - .
: ; - ; ; 6- ; (--).
. 40 , IIIII II , 23 - , -- - . I (20 ) --01, , -; II (20 ) - ,
. -. , - , , , - , -, , , . - . I , - , - - - - II , , . -, .
, , - , .
062
. ., . . -
, ,
. - () () - . - - 24 56,7%. () . , , , , .
- .
. 295 , - (, , , - , , ). 95 . , . -
, - ( (), ( - ()). Statistika 6.0.
. 42,3% , 30,3% (=0,048). ( 20 ) 64,18%, 36,4% (=0,036). 11 20 -
, - (=0,03), (46,9% 14,3% , =0,03). - (=0,0050,007), 10 20 - QTc
(=0,011) -, . 11 20 - 1,2 (=0,015). (=0,01).
. - , . , -, . - , - (, ).
063
. ., . . , ,
: () .
: - 2 (, ) 2059 . 519 , 222, 297. -- , -.
: (),
,1999). STATISTICA 8.0. - () 5%.
. 5,7% ( 7,2%, -3,7%, p=0,58) , , .
. , - , , .
064
. ., . ., . ., . ., . ., . .
, ,
-
, 2013; 12 ()28
065-066
: - .
: - (n=32) . 43,43,1 , 18,641,9 . 30 - (), - . 65,42,1 , 40% . -
- , - .
. , - - () 90,7% , 75% SCORE, 15,7%. , (), , : , -, , . - ()
93,8% , 34,4% . - 59,4% , 21,9% . - 53,1% ; 57% - . - , , 16,7%. ,
56,7%, 13,3%, 26,7%, 66,7%, 1023,1 , 912,7 . - 96,7% -. 36,7% , - .
- 43,3% , 13,3%. , , . - 13,3% , 6,6% .
: - , . - , - , , - , , .
065 - : ( 7 )
. ., . ., . ., . ., . .
, , ,
: - () - () , . , 7 .
: - 29 - . 29 (15 14 ) , ( 57,72,2 ). . . (2008 .) - -.
: ( 68%), 69% ; 31%. , II . II , 13,8% . : (51,7%) - (38%). .
10% . . 10% - . 7 , (58,6%) - , . - , 76,7% - , - 10% .
. , 38%, - 44,8% 17,2% .
: -, - , , - .
066 ,
. ., . ., . ., . ., . .
- - , ,
- () - , , , , . () - .
: - () , (), .
. 28 , 4668 IIIII . - (), , 50 100 , 1 . 2 , 1 . 70 .
-
, 2013; 12 () 29
067-068
. HOMA2-IR, ISI0,120.
. 1 . (p=0,025), 2 , (=0,049). - (, 1999 ) - 4 8 (p=0,006). , 10
. 2 , (=0,045). HOMA2-IR , ISI0,120 , (=0,036). - ISI0,120 - ,
.
. 1 . . , .
067
. ., . ., . .
. . . , ,
: , - - - (), - S, .
: 80 -: 55 ( 38 84 ) 25 ( 58 95 ) , . , -, - -.
: ( 58+11,9 , - 69+10,7,
-
, 2013; 12 ()30
069-071
. - - 2 - .
069 : .
. ., . ., . ., . ., . ., . .
-, ,
- .
. 11 (9 2 ) 41 59 - . - ( , , ). 2 - , - . - , -, , . .. , . - .
1- (- ) , 4- - , 6 . , . . , , , , , , , , - , , .
. - 3 5 . - , 2 (18,2%) , 9 (81,8%) 6 (54,5%) - , 4 (36,4%) - .
- 7 (63,6%) ( 4 -, 3 , 6 (54,5%) . -. . - 40%, . 5 (45,4%) - , 4
(36,4%) . 6 (54,5%) . 6 (54,5%) -, 3 (27,3%) .
070
. ., . ., . . . . .
, ,
Na+ .
: Na+ - ().
: 49 , 26 23 . 58,459,2 , - 10,499,8 . 11 2 38 3 . : 2 , 9 38 -
. 13 - ( 58,337,8 , 6 7 ). (>0,05). - . . - Na+ 24- .
- .
. Na+ 201,58112,22 /. 190,61103,05 /. - (=0,25). (r=0,37, p
-
, 2013; 12 () 31
072-073
138,00 /, 25- 104,00 /, 75- 226,00 /) (=0,34).
- . , - 100 300 / - : (p=0,03), (p=0,04) (p=0,03), ( 103/71 . .
127/82 . .). - - : (r=0,45,
-
, 2013; 12 ()32
074-075
51,94)), 7 (117 (70,8162) / 94,3 (62113) /)), - - (7,17%
(2,67519,225) 2,68% (1,7453,125)). - (40% (3745) 48% (4250)).
-,
-
, 2013; 12 () 33
076-078
076
. ., . .
, ,
. () () () .
. - 60 - : IIII , ( IIIII ) (65,90,5 ). 60 (64,70,6 ).
. , 57,8% - - , , . 1/3 -: (61%), (21%), (12%) (6%). 32,4% . -
(11%). - , .
( , , ) (25,4% ) - (9,2% ).
, : III (46,7 28,3% ), (46,7 38,3% ), (35, 0 23,3% ).
III () 55,0% -, , (20,0%). II (41,7 23,4% ) II (18,3 0% ).
- . III III (76,9%) IV (100%). , (3 ) 66,7% IV , , II (7,5%) III
(23,1%).
. - , , III , II III , - -. .
077 ? ( ACS-Registry )
. ., . ., . ., . ., . .
. . . , . . . . , ,
- () - W. B. Kannel 50 . -, , . , - - 4060% , - , , - . , , . .
100% !
: - , - () . , - , .
. - (ACS-Registry). - , . . , . . -. 305 , 4 . , 13 -. (.) 155
., (.) 150. - ., . . 99 . 1, 51 . 1.
. . - , - () , - . -. , -, %: 7 ./28% 5 ./18% =0,6818 N: 7+5=12.
23 , . . 161 115 . -: =0,0500. , 3612 ., 8 . . . , -: () 1%, 5%, .
. 15% (
-
, 2013; 12 ()34
079-080
- , - .
. 4- - 34 (30 , 4 ) - , 51,43,2 . 2 : 1- (n=16) (, - , ) -, , ,
, 2030 ., 1012 . (n=18) . - - . -: 6- (6), () (2, 2).
. - - : ( , 2,320,10 1,790,11 ;
-
, 2013; 12 () 35
081-082
- (=0,691 0,716, ). , , , . 23 ( 0,032 /) 2 : 11 , (2 -, 1 9 ),
12 - . (=0,022), - - ( - 0,477, =0,018). - 2 (95% 0,19 20,55).
: 0,032 / (=0,022) - (, , ). - (95% 0,19 20,55) .
081
. ., . ., . ., . ., . .
. . . , , . , ,
: - -- , - - , .
: 82 -, 7 2011 2012 . 11 (13,4%) , 4 (4,9%) , 40 (48,8%) 27
(32,9%) -- . - - . - 7 -. 30 . , , 30 .
: - : 1,09 (0,29) /; 1,12 (0,28) /. - (=0,33). 2 : 1 31 ( 7 , 4
- 22 ); 2 51 -. - (=0,841 0,244
) (=0,593 0,663 ) . - : , , , , (- , , - , , - ). - .
: - . . - - - .
082
. ., . . *, . ., . .
- . . . . , ; * , ,
: () (), -- .
. 101 - , 57 -. 22 . : , : -- () -, - - , - , -.
. - - - (389,06191,02 /), 7 - ( 50 /). - - - (14,811,77 /)
(17,9613,78 /) (>0,05). - , (4,411,98 / 5,722,65 /, ; =0,037).
(2,760,22 /). - - : () ( r=0,6281, =0,004; r=0,5424, =0,0164), - ()
() (r=0,6963, =0,0009; r=0,5504, =0,0335), (r=0,5101, =0,0256;
r=0,5114, =0,0252).
. 1. - , .
2. - - .
-
, 2013; 12 ()36
083-085
083
. ., . . *, . . -
. . . . , ; * , ,
: - () , .
: 89 II , 45 (53,3%) 44 (46,7%), 55,511,65 . 33 . - : , : -1
(-1), -6 (-6), -4 (-4), --17 (-17), - , - - .
: , , - - - : -1 (R= 0,40, p=0,007), -6 (R=0,34, p=0,02 R=0,43,
p=0,002 ). -6 (R=0,23, p=0,04, R=0,29, p=0,01). - (R=0,31, p=0,04,
R=0,47, p=0,02), -6 - (R=0,35, p=0,049). - -17 , (R=0,34, p=0,04 ).
- - : (Beta=0,264, p=0,00), - (Beta=0,282, p=0,00). - , (
Beta=0,297, p=0,00, - Beta=0,291, =0,00), - . , , , - .
. 1. - , .
2. - (Beta=0,264, p=0,00) - (Beta=0,282, p=0,00).
084
. ., . . *, . . -
. . . . , ; * , ,
: () (), - , .
: 70 , 51
, - . 19 . : , : -1 (-1), --6 (-6), -4 (-4), -17 (-17), - , -
.
: - -6 (3,772,72 1,911,95 , =0,00001 3,653,16 2,043,07, =0,0012
-). - - , , . , , -17 . - () - (=0,00001 =0,0056 ). - - - (=0,037).
( 12 =0,25; 13 =0,006; 23=0,14 ; 12=0,05; 13 =0,001; 23=0,29 ). - (
12 =0,31; 13 =0,03; 23=0,02). , .
- - .
. 1. - , -, -1, -6, -17, - .
2. - - .
085
. ., . .*, . ., . .
- . . . . , ; * , ,
: - () , - .
: 72 , 40 - (). 33 - . - . : , : -1 (-1), -6 (-6), -4 (-4), -17
(-17), - .
: : - (R=0,83, p=0,00), -1
-
, 2013; 12 () 37
086-087
(R=0,41, p=0,01), -6 (R=0,57, p=0,0004), -17 (R=0,89, p=0,02), -
-1 (R=0,61, p=0,00005), - -6 (R=0,70, p=0,000005), -1 -6 (R=0,55,
p=0,0009). - : (Beta=0,569, p=0,04), - (Beta=0,506, p=0,00), -1
(Beta=0,268, p=0,00), -6 (Beta=0,370, =0,0008). (Beta=0,323,
p=0,048). - 2,6 /, (=0,001). : 2,6 5,7 / - 3,5 . -. - 2,1 /
(=0,02), - 2,14,1 / 5 . -1 1,1 / (=0,0001). -1 0,9 1,3 / - 3 . -6
3,0 / (=0,003). -6, - 2,1 2,3 3,1 3,4 /.
. 1. (, -, -1, -6, -17) , .
2. 3,5 2,6 5,7 /, 3 -1 0,9, 5 - 2,14,1 /.
086
. ., . ., . ., . ., . .
-,
- , -, () .
. .
. (), (), , - , 284 -. , : , - , .
. 65% - 45 (122 ), . , - - (
-
, 2013; 12 ()38
088-090
, , - - 40% 20%, 20% 50%.
. , 30- - -3 , : -, , -. , - .
088
. ., . ., . ., . . , ,
. - - .
: 6 - .
. 50 52 73 , . . (-, , - , , ). - 23 6 . : - (); (.); (). 2 -
(30 20 ). - ( ; ; ).
: 6 - . -, ; (0,660,69); (0,630,65). ( ) . ( 0,650,65 0,630,63).
, - . (0,640,60); - (0,650,65). (- 102135,2 115,5118,5). - , (
54%51% 65,5%60%), ( 54,12%48% 54%51%).
. 6 - , ( , ). , - -.
089
. ., . ., . . ,
. . . , ,
. (-, , ) ().
. 50 , 55,59 , - (), 41 (82%) . 39 ST (ST) 11 ST (ST). , , . :
-, - , , -.
: 8 (16%), 1 (2%), 25 (50%), () 4 (8%). (74%), (68%), (67,3%).
20 (48%), 12 (24%). - 4 (8%) . : 48 (96%), 1- (2%) 1- (2%) . Md
147,5 (78,8; 262,5) . 47 (94%) 12 . I Killip 34 (68%) , II 14
(28%), III 1- (2%) IV 1- (2%). (>60 //1,73 2) 10 - (20%). () 41
(82%) . 11 ST 30 ST, - 76,9% (39 ). 1- - () 17 (41,5%), 23 . 39 ST
33 (84,6%). () 13 (33,3%) 12 (30,8%). - - 7 (17,9%) , - , 1- (2,5%)
, . 11 ST - . 0,40 3 (6%) . ( 2=25,045; p=0,015). 4 -, , 2 . 14%. -
2 10 . - .
. (-, , ) , - , 14%, .
090
. ., . ., . ., . ., . .
, ,
: .
: I - (), 20 - -
-
, 2013; 12 () 39
091-092
50 /; II (), 20 20 /. 2 , 6 , 24 , - . , -, . . (1990) 45 () ,
(.%) , . - - (TGF-1), (FGF-2), I --1 - Autostainer 360. , - , - . 9
() () () 1 2 ( ).
. .
, -, , , .
, .
, . , .
- , . , FGF-2 3 .
- GF-1 6 , .
, GF-1, - 3,5 5,5 , - , , , .
I , . -1 - .
091 - 2
.., ., . .
, ,
: - - 2 .
: 81 2 . - 2 : 1 - 43 2 (0,05). 1 - , , - (>0,05), (0,05) 2 .
- - , (>0,05). - 1 - 2 (>0,05). - (r= 0,392; p=0,015 r=
0,463; p=0,003 --). (r = 0,340; p=0,026). (r=0,448; p=0,006)
HOMA-IR (r=0,350; p=0,036) . - - , (r = 0,495; p=0,002; r = 0,538;
p=0,000) - (r = 0,465; p=0,003); - (r=0,415; p=0,010).
: 2 , -, , , - .
092 :
. ., . ., . ., . ., . ., . .
, ,
. , - - ( -) () () - .
. 60 - 1111 , , - . 16 5/16010/ 160 /. () -04 Meditech, . - -,
().
-
, 2013; 12 ()40
093-094
12 (). (YI).
. ( ) 1 . 100% , 2 . 83,3% , 3 . 63, 64%, - .
- ( 1- 3- ); 3 (13,88 0,48 /) (0,01,
0,05) - (12 .). 1 . , (3 .: 13,880,48 / 12,410,28 /, 0,01). (YI)
( 6,4 0,15 1. 7,630,23 3 . , 0,05). - CAYI 2 . (0,05), - 3 .
. - . ( ) , , - .
093
. ., . ., . ., . ., . ., . .
, ; - , , ,
: - ,
: 488 3059 : 294 2 1,2 130 - , , 64 2 ., 1,2 . (. ). 48,66,1 ,
17,56,8 , 12,54,7 . , , . - (20082010) . -- () Bruce. -: (), - ,
(), (ME). - . - STATISTICA, 6,0 ().
. . , - (p
-
, 2013; 12 () 41
095-096
100% . , II . 100% I ; II 50% .
: - - , -, , . -.
095 -06
. ., . .
1 . . . , ,
, - - (). . - , - . , , -.
. --06: 1) ( ) -, , ; 2) , - .
. - 60 ( 40,11,6 ), 40 . - . - (), - . , - (). ( Statistica
6.0).
. - , , , , - , -.
, , , . , -, , - , - , . , . - .
. ,
, - , .
, , - .
096
. .
1 . . . , ,
. - (), - .
. 80 - , . , , () .
. - , . - () , : 1) ; 2) - , , ; 3) ; 4) ; 5) .
, (), - .
() . -: , , , . - , , -. , , -, . , , .
: 1) -, - ; 2) QT - QT (QT); 3) .
, , .
-, , ,
. : I (): 1) -; 2) . II$5 (): 1) ; 2) ; 3) ( ); 4) (, , ); 5) ,
- QT, -.
, - -
-
, 2013; 12 ()42
097-099
. .
097
. ., . ., . . ,
,
. - - .
. 85 () 40 84 , 68,7% , 31,3% . 21 . () 180 - 90 2 /. - ( (),
--, -, ). - , - , , , .
. 85 7 (8,2%). 6 (7,1%), 1 (1,2%). -- PLATO 1 (1,2%), ( PLATO
11,6%). (, , , ) 5 (5,9%). 1 (1,2%) -, - , ( PLATO - 0,9%). - ( 50
) 6 (7,2%). 2- (2,4%) - ( I 1,2%, II , I 1,2%). - , -, -. . - 1
(1,2%) , - 64 ST. - 325 , . 5 , .
: 1. - . 2. 1,2% . - 5,9% , , - PLATO. 3. -. 4. 1,2% . 5. .
, - - .
098
. ., . ., . .
, ,
() - - -- () - (). - - (), , - . .
: .
. 70 . 64,510,2 . - () II 39%; III 49%, I 3% IV 9%, 6- . I/D .
.
. 24% , 45% - , 2535% . 3 : 1- DD (25,8%), 2- ID (25,8%), 3- II
(48,4%).
1- III IV (65% 16%). , 6 , 251,799,5; () 32,314,0 / 2. -
(37,5%). 50% - , 25% .
2- IV (4%). , 1- 305,097,0 (
-
, 2013; 12 () 43
100-101
() - - . - - () . .
.
. 100 - , - . 2010 . ( ASAS, 2009) ( K/DOQI, 2007), () MDRD. - .
SPSS Excel2007.
. 77 (77%) - : 4210,98 . (2066 ), 14,998,6 . - 39% [ 31; 47] ( ,
p
-
, 2013; 12 ()44
102-103
. 18 , - 34 TIMI III - 11 (61%) , 5 (27%) - TIMI I 2 (11%) . ,
-- 56 5 (45%), 6 (55%) ST.
, , - . - - .
102
. ., . ., . .
, ,
- , - . - .
. () - - . .
. 100 - () ( ), -, 2155 ( 48,20,7), - . 2 : , 50 ( 38%, - 62%),
50 (36% 64% ). - , . 2 94%; 2 92%, 3 - 8%, 3 ; 2 - 60% 3 40%. II (
) ( ).
. non dipper 65,6% 53,1%, . - , - () , . - 88%, - 76%, - 70%
--14% (p=0,009). , , , - : dipper 25,9% 40,7% , non dipper
33,3% 25,9%; night peaker 29,6% 18,5%, over- dipper 11,1% 14,8%.
- , - (94%) - , 78%- - , () 94% (p=0,0001), -2% (p=0,002).
. , non dipper, - , - . - -- , - . over- dipper - --. .
103
. ., . ., . .
, ,
. - -: , - .
. 130 -. : 40 (- 1 ); 30 ( 10 ) - ( 2); 30 1 ( 3); 30 - 1 , (4
). 222 . - - (a. carotis) (a. radialis) . : - , , , . - Statistica
6.0.
-
, 2013; 12 () 45
104-105
. - . , - , , - . - .
104 C
. ., . ., . ., . ., . .
. . , ,
: () () - (), , , - .
: 66 49 72 , 36 (4964 ) 30 (6372 ). 10 20 . 180/100 . 240/120 ..
- ( 80% 2 , 20% , ).
66 (1 16%, 2 84%). - , . . .
: , 1 140\90 . , 2 3 : 1) - , - 23% 2) , , , , 37% 3) ( , , , -)
, , 40%. - 3 - 1 , (, -), 17 , , 9 23 -.
: - , . . , -.
3 . . .
105
. ., . ., . ., . .
, ,
: - () .
. 305 - 13 - () 3598 . 140 - . 3 , , . ESN/ ES (2007 ). (
.,1986), . : , - , , - .
. - , , , . 3040 , , , . - 3 5 , 12 . ( 30 ) 40% , 50% . , . -
38% .
50% - , 7% . - 3% ( ) 15% ( ). -, 25% - , -.
. - - . - , , - .
-
, 2013; 12 ()46
106-108
106
. ., . . -
, ,
, . , - - .
2012 - 84 40 , 5 (6%). : , 3 (2 ) 2 (1 ). - - > 30 /2.
2012 (). -, .
, - () 2,0 /, () 1,1 1,3 /. L- 70 .
. 29 24 , - 200/100 .. , - . . : 66 /, 180/80 . 4,1 /, 2,06 /,
0,74 /, () 0,42 /. () . - , .
39 , -. - 3. 5 - 240/120 .. - . 3- , - , -. , , 180200/110120
..
: 80 /, 210/110 .. : 5,2 /, 3,4 /, 0,85 /, 2,2 /. , . .
, 40 , , .
107 III
., . . . . . , ,
: - () - () III .
: 35 (-20, -15; 56,798,2 ) III . - () Mini-Mental State
Examination (MMSE), (), 5 7 12 .. 5 . - SF-36.
: 12 74,28% (26 ). - - 141,611,9 128,625,43 86,241,02 77,211,42
.., 52,411,27 38,274,23%, 36,732,82 29,483,15% (
-
, 2013; 12 () 47
109-110
- (), - , . (VM) , - . . (2007). (Pet) (Einc), ()
Moens-Korteweg. - (LQ; UQ), , LQ UQ .
. 1- 0,9 (0,7; 1,2) , 2- 1,0 (0,8; 1,2), 3- 1,0 (0,9; 1,3),
p>0,05; >0,9 42,3% 1- 64,3% , =0,032. 1- 23,8 (19,6; 30,2) 2,
2- 28,7 (22,9; 37,4), p=0,048, 3- 28,7 (23,8; 32,2), p=0,038; VM
0,209 (0,154; 0,260) /, 0,253 (0,207; 0,284), p=0,039 0,234 (0,198;
0,333), p=0,064. 17 (65,4%) 1- , 17 (56,7%) 2- 15 (57,7%) 3-; - ()
4 (15,4%), 4 (13,3%) 2 (7,7%); () 4 (15,4%), 6 (20,0%) 7 (26,9%,
=0,035 ); - () 1 (3,8%), 3 (10,0%) 2 (7,7%). , - 1- , =0,035. Pet,
Einc (), p>0,05. - Pet Einc -- V- - 3 - =0,086. 1- 55,5 (50,5;
61,5) , 2- 58,5 (53,0; 62,0), 3- 63,0 (59,0; 66,0), =0,002; 86,6
(73,5; 97,5) , 91,7 (80,0; 100,9) 98,3 (79,0; 108,8), p=0,059; 31,0
(28,8; 35,2) / 2, 31,3 (28,1; 37,3) 32,1 (28,9; 35,8), p>0,05; -
() 106,5 (99,5;112,5) , 112,5 (100,3; 117,5) 115,5 (103,0; 119,5),
p=0,071; / 0,94 (0,91; 1,01), 0,96 (0,91; 0,98) 0,97 (0,94; 1,04),
p=0,048, - 139 (130; 148) .., 145 (136; 152), =0,053 144 (130;
157), p=0,059, 50 (44; 57) .., 56 (54; 65), p=0,003 60 (50; 70),
p=0,002.
: VM , - ; 23 . . Pet Einc - , , /, ; , .
109
. ., . ., . . ,
,
, - - - - , , . - ().
: - .
. - , (n=114), ( 3 -
) (n=34) - 3555 . . .: () (). SPSS 13.0. - MSD.
. : 13716 .. vs. 13011 . (
-
, 2013; 12 ()48
111-113
, - . . , - SF-36, -.
. -. . 6- 198,032,8 378,515,6 (p
-
, 2013; 12 () 49
114-115
: I - (), 20 - - 50 /; II (), 20 20 /. 2 -, - . - , -, . .
(1990) 45 () () , - (.%) (), ().
, 2 c 6,830,30 .% 8,61,39 .% (p>0,05), 6,830,30 .% 8,720,06
.% (
-
, 2013; 12 ()50
116-117
7,6%, 34,3%. - III IV , 62,4% 27,1% -; 10,5% II . I II , 79,3% .
. . - I II 71,8%.
: 1. - .
2. - - .
3. . - .
116
. ., . ., . ., . .
. . . , , 81, ,
, , - , , - , , . .
. - () - - .
: 95 - . 87 8 50 84 ( 67,6 7,1 .). 2 : I 52 , - ( ) . II 43 , -
, . 1012 . , , , , - , , (>0,05). - . I 25 (48,1%) II III 8
(15,4%); 6 (11,5%). () 18 (34,6%) . II 37 (71,2%) III 2 (3,9%) . 21
(45,7%) . II II III 16 (37,2%) 7 (16,3%) ; - 3 (7%), 13 (30,2%). II
22 (51,2%) III 2 (4,7%) . - 19 (46,3%) . -
- (>0,05).
: - -, , - . I 10 13,76,6 / 67,95,7 / (
-
, 2013; 12 () 51
118-119
, -, 19, - 6 . - , . CAR Aperio Scan Scope CS (Aperio
Technologies Inc, ).
. 1 2 (294.9 vs 3711.3%, =0,3), ( 240127 vs 22082.6 , =0,1) -
IIV (NYHA). - 4 1 , 3 2 . - - 2 1 . 5 3 -. 1 (4114%), 2 (2217%,
0,05). SF-36, , SGRQ (p0,05). 1846G CYP 2D6 .
. - CYP2D6.
119
. ., . ., . . , ,
( ) - - , - . . -, - . - : 60.3% (5574 ), 37.7% (7589 ) 2% .
- .
, (86%), . , , (52%) (38%).
- . - , - . 34 . - . - , - . , - , -, , , , , - . ,
-
, 2013; 12 ()52
120-122
, - .
, , ( , 72.3% , 98.2% 100% ) - , - . , , , , - . 460 2 - , -
.
120
. ., ., . ., . ., . ., . .
-, 1, ,
.
: 20 ( 69,4 ) () II , 10 . 15 5 , 12 , 8 II III , 3 ( ). - 10 2
( 8 20 ). , 8 (- 20 1 2 ). - , - , , - --, . -, , , - . - . -
-
, 2013; 12 () 53
123-124
4 . . . -. 62,91,1 . 17,50,9 . - - - . . (. --). , - -, -, - ( .
-). - Friedewald W. T. et al. (1972).
. -262 - (2 (p=0,01), (p=0,015), (p=0,001), (p=0,03), (118,610,5
vs 97,03,4 mmol/l, p=0,05), LDL- (4,00,2 vs 3,30,13 mmol/l,
p=0,001). . - , , , , - (p=0,002). (16% 1,6% p=0,005).
, 2,5 - (24% vs 9,4% p=0,04 39,5% vs 19,3% p=0,03, ). - ,
NYHA>2 - , (18,4% vs 5,3% p=0,01).
. , , , LDL-- , , - .
124
.., . ., . ., . . , ,
, - () - () , . - .
: , .
. 114 , 64,10,9 , 56% 44% , 8,60,8 . , - , -, , , ( 2,5 ). - -
.
. 30,90,4 kg/m 2, - 105,40,7 cm, 27% , 82,5% , 16,7% , 10% 48%
-. 41% , 26,7% , 12,3% 22% .
Q 70% , -
-
, 2013; 12 ()54
125-127
71% . - 13,80,8 /, 25,7% . - 15,8%, - 27,3%. : - (F=14,2,
p=0,0003), (F=11,5, p=0,001), (F=13,9, p=0,0003), - (F=9,8,
p=0,003), (F=9,6, p=0,003).
. : , , -, , .
125
. ., . ., . .
, ,
. () () () .
. 42 - (/, 24/9) - 37,56,3 , III (27, 63%) IV (6, 37%) . (-). ,
- . (1995). - 2 : - . - , : , -, , , -, .
. 3 ( 66,221,2 28,919,7 ; p
-
, 2013; 12 () 55
128-129
. ., . ., . ., . ., . ., . ., . .
, ,
: () 2 - .
: 20102012 - 65 ( ) 60,39,8 ( 75%) - 2 : 1 () 2 (n=28) 11,65,7 2
2 (n=37).
, -, -, , . . Judkins (1967 ). : (), - (), , (, ), -I, ( -I, ),
( ()) (Cobas Integra 400 plus); : - - (hs-CRP) (Clima MC-15), -1
(-1), 6 (-6), 8 (-8), (-) (IMMULITE 1000), CD40 (sCD40 L) (Bender
MedSystems), CD40 --9 (MMP-9) (Bender MedSystems and Bioscience
company), -1 (TIMP-1) (Personal Lab); -1 (Dynatech) (Humalyzer 2000
Human).
: 1 2 - hs-CRP, -, MMP-9; (), , -1 TIMP-1. 1 - : , , , , / -I; :
-1 . 1 (
-
, 2013; 12 ()56
130-131
. () - - - () .
. 64 - 17 , - 58,0 , -, - . 5 7, , -.
. - - , . - , ( 7 -). ( > 0,1). - MANOVA . (=0,008) 7
(=0,83). (=0,05). 7. - (=0,84). -. . - , - .
. - , , - . . - - .
130
., . . , ,
. - (-) - () ().
. 36 (, 58,1 ). - (-04--3, , ).
-: QRS (FQRSd), 40 (LAS40) 40 QRS 25 (RMS40). (InVisor, Philips,
) - .
. FQRSd (rs = 0,68, p
-
, 2013; 12 () 57
132-134
. - -. - - 7 (63,6%), - 3 (27,3%). S.viridians, S.bovis,
S.aureus, , .
. , - . . - .
132
. ., . ., . ., . ., . ., . ., . .
, ,
- .
. - - .
. 2010 2012 69 30 50 (41,84,2) . - , , - , - () .
. 48 , 59,33,24% . - - 50 (76,9%), - 46 (70,7%), 7 (10,7%), 1 9
(13,8%) , 7 (10,1%). 17 (24,6%), 13 16 (23,2%). ( II, III 3,03,5 )
24 (43%) , ( -) 44 (63,8%). 13 (20%) S T 2 III, aVF, V5-V6. -
-
, 2013; 12 ()58
135-136
; 2- 36 , , - (). 15 . , , 6-- , , - .
. - - - - . 6 ( 2 . 3 ), 40 / 2 .
, 15- - , , 35 (79,5%) , . - 50,0%, - 68,2%.
( 57,1%) - ( 62,7%) .
, , , -, - -.
135 - .
. ., . ., . . , ,
() , , , - , - - , () .
. - - III () - / .
. 38 - III - () II 4567 , 26 12 . - , -, . - 4 : , - .
. 20 . 15 (44,1%) - (), 19 (55,8%) () 14 (41,1%) . 5 (27,7%), 8
(44,4%), 5 (27,7%). ( ), ( ). (, 1,170,03 &1,030,02 (
-
, 2013; 12 () 59
137-139
137 -
. ., . ., . ., . ., . .
- , ,
: - - - (), - , 1 GARFIELD.
: 133 ( ) , - . . 6535 , 1 GARFIELD.
: 65 33,8% , GARFIELD 73,8% (
-
, 2013; 12 ()60
140-142
15 . 7 . (, Servier) 20 3 100 3 . 14 .
. 5 3 (
-
, 2013; 12 () 61
143-143
- , , Q Q
. 3 - 1 (n=134). 1 - 35 (19 16 ) Q ( 56,20,8 ); 2 32 (15 17 ) Q
(56,11,0 ); 3 33 (18 15 -) IIII (53,50,8 ); 4 34 (23 11 ) ,
(46,90,9 ). , - , , - () (). 25 / 2 , 30 / 2 ; . - 12 , , , , (). -
, , , , (), (). - - (Hb%) . - STATISTICA 6,0.
. , , - (=0,05), , 25,60,6. 1 30,30,8 / 2, 7 10 . 2 29,90,7 / 2,
2 ST 7 , 12 . -, , 32,00,8 / 2, 3 , 3 22 11 - 96,11,5 .
1, 2 3 , - ( 0,05) - (5,40,2; 5,60,2; 6,50,5, 4,90,1 -) Hb 1, 2,
3 (6,50,1; 6,20,2; 6,80,2; 5,60,1 ). 1 26,7% , 2 13,3% -. , 3 2 , (
23,3% ) 2 (46,7% ).
1, 2, 3 , - , (=0,001), (3,10,1; 3,00,1; 3,20,1; 2,890,1 );
(1,00,04; 0,90,03; 1,10,1; 0,590,04); (2,20,2; 2,00,1; 1,90,2;
1,480,1); 1 2 , , - (=0,001, =0,005), (1,00,04; 0,960,04; 1,30,1;
1,360,07); 1 2 (=0,005, =0,001), (4,20,3; 4,50,3; 3,40,2; 3,00,3
).
. , - Q , Q , -
IIII -, 2 , . - .
143
. ., . ., . ., . ., . .
-- , ,
() , - , . , - () , . - .
: - , - () .
. 119 5276 , - . 9 . 23 -- -4 -8. - ( ), (- ), - () - () . -
.
. - - ( ) - ( ). , - , .
- (, ), -. .
, , . -.
. - , , -, . - - . - , , - , .
-
, 2013; 12 ()62
144-146
144
. ., . ., . ., . ., . ., . .
, --,
: - () () - () - - .
. 75 - ( 567,8) II , 2 , . 1- . -- (), . - (CAVI), - (), (). 5,0
1,25 ( -, Servie, ). 3 . - - STATISTICA 7.0 (StatSoft Inc., ).
. - 3 . - () . CAVI (9 /); . 3 . CAVI 13% 11% (
-
, 2013; 12 () 63
147-148
(n=22) If- ().
. () 17,0 (3,0; 875,0) 208,0 (4,75; 396,0) , 0 (0,0; 0,5) 0
(0,0; 0,5) . - (), .
- () 36,0 (24,0;48,0) 26,0 (6,0; 39,0) . 0 (0,0;2,0) . () - 0
(0,0;1,5) . , >0,05. (25;75).
27,5 (0,75; 506,0), 70,0 (2,5; 240,0), 0 (0,0; 0,25) 0 (0,0;
1,0) . . 26,0 (9,5; 171,0) 22,5 (17,0; 141,0) . 0,0 (0,0; 3,0) 0,0
(0,0; 1,75), 0,0 (0,0; 1,0) 0,0 (0,0; 1,0), 0,0 (0,0; 1,0) . ,
>0,05. (25;75).
QT : QT (F) 407,14 18,07 401,5 14,92 , >0,05. QT - QT (F)
404,0 42,56 385,58 19,21 , =0,01. ( ).
. , , - , - -.
147 ,
. ., . . . . .
, ,
. , , - (44 ) (4559 ) .
: 159 - 29 (40,33,2 .) ( 1) 130 (53,43,5 .) ( 2) (), 2010 . : ,
, , : . , , , , , , , - , , , , , - (), : -, , . 2012 . - .
. -: (93,1% 1 , 85,4% 2 ), (55,1% 31,5% - (p
-
, 2013; 12 ()64
149-150
(Me) . - .
: sE- (sE) + (
-
, 2013; 12 () 65
151-153
, - TGF-1, .
151 -
. ., . ., . ., . ., . ., . ., . .
- . , ,
: - .
: MMSE, , , , , - .
: 43 - - , - - . . . 599 (-27, -16). 5., - 3., - 34., - 1. 30 .
8 -. - 35 . 22 -. 36 (83%). - 13. (30%), - 5. (11%), - 9. (20%). :
7. (16%) , 22. (51%) -, 10. (23%) , 4. (9%) . - , . - , - .
: 1) 84% - - , 31% .
2) - - , - , .
152
. ., . ., . ., i ., . ., . ., . .
- . , ,
: - -
: - MMSE ( , , , , - ) Mini-Cog ( , - ).
: 43 - - , - - ... 599 (- 27, - 16). 5, - 3., - 34, - 1. MMSE 7.
(16%) , 22. (51%) , 10. (23%) , 4. (9%) . - , -. 15 35. Mini-og -
11 (25%). , , 3 5.
: MMSE , - . Mini-og , .
153
. ., . ., . .-
, , ,
: - - () II , , , -, 5 .
: - ( PFIZER) 5 II . () , (). 2 27 . 1- , 2- - . .
: - () (), () () - , . 5 .
. 1- 30 5 , 1 . 2- 30 11 , 0,9 6 . 1- 9 , , 2- 23 18 . 1 .
: - . -, , .
-
, 2013; 12 ()66
154-156
154
. ., . ., . .-
, , ,
: - - () () .
. 30 - II 6070 . 3 .
2 : () : 5 2,5 . (, ) 100 .
: - () 08.00 22.00 (), - () , , , . . : , , , -.
: - , . , , , , - , , - . 3- - , . 1- - 4- , 10 . 2- .
: , , - .
155
. ., . ., . ., . .
, ,
- () () - () () . 28 -, -
48 , 11 (39%) 17 (61%). 761,29 . - - - - . NIHSS 1 21 . , - .
4872 - . , 80. - (), . 1 2,5 5 (15 , 54%), 2 - 10 (13 , 46%). , 2 1
(761,05 652,08 ). 1 2 4 - 2 (=0,044 =0,026). - 2 . - 13 - (46%). 2
- 1 (=0,021). 1 2 - . - 1 : 21 NIHSS 1 6,5 [1; 9] , 2 11 [5,5; 13]
, (=0,018). 21 1 (=0,055 =0,06 ). , -, 4872 , --, . .
156
. ., . ., . ., . .
, ,
. () ().
. 100 (60 40 , 589,5 ) , 50 . () - -, . () .
- R-R-. - R-Ri - on line -
-
, 2013; 12 () 67
157-158
, - . S - () , S S -, ( ), , .
. () () (, ) : =0,360,07, =0,180,06; =0,380,06, =0200,04;
=0,950,12 .. =1,00,2. - S (=0,680,06., =0,660,06) (S, =0,480,06.,
=0,470,06). S=0,480,04 .., S=0,300,02 ..
10 - () (), (
-
, 2013; 12 ()68
159-160
68 . - ( - , . .), 20 , - . - , -. , , , .
( 50%) - , . - - , -10 - .
, -, , , .
159
. ., . ., . . , -
4, ,
: - () ().
: 14 , 66,7 [57;75] , 1 31 2012 . (2007 .) 14 , 10 (71%) Q (), 4
(28%) Q. 48 - RIFLE (ADQI, 2002), R- , I-, F-, L- , E-- . 1- (<
0,5 // 6 ), 48 ( 25%) / ( 26,4 /). () -, MDRD, EPI. , - ().
(Micral-test, , ). , - 1, 3, 6, 14 - .
: 14 . RIFLE 4 (29%) R, 10 (71%) I. - , F, L E . 14 : - 12 (86%)
50 /, 2 (14%) , I , 100 /. -EPI . -EPI 1, 3, 6, 14 : 54,5 [39;82],
61,7 [36;88], 63,6 [29;90], 63,4 //1.73 2 [33;99] (//1.73 2). - ,
,
, .
: - 100%. - -, - , - -.
160 ,
. ., . ., . ., . ., . ., . .
, ,
: , , - 65 .
30 696,8 , (). 20 , 65 ( 496,3 ). 26 , 12, 17 ( ) 3 -. , , , -.
, 7 , - . -, -, , , (19 2, ). , - 6 , .
, (60%) , - , - , , . - 25%. - , . - - : , - --1 , 5060% .
-, : , -, -, , , , , . (, ) - , ( 6 14 ) - .
, - , , . -, , .
-
, 2013; 12 () 69
161-163
161 ,
. ., . ., . ., . ., . .
, ,
: - , .
: 36 -, 29 , 7, . 54,78,1 . , , -. II ( , - , , - ) 10 . - () 86
6,8 ., , - . - , ( () 455,7%. - , - . - , , , , - 5 2 . 7 (15%) -
7,5 2 - . 3 - .
. 2 10,34,1 /, - . 3 70 ./, - 50%, 90% -. 1,9 0,78%. , . , ,
-.
. 5,0 7,5 2 - , , , - , . - , .
162
. ., . ., . ., . ., . ., . ., . ., . ., .
, , ,
: - .
38 ,
48 9,6 , - . 22 , 10 . 16 . 21 , 17. - , , - (). 12 , , -, , - .
-: 180 , 90 2 . 30 , - , -, . - .
- -, - , , , . . , , . 2 - .
. , , . - . .
, - . - .
163
. ., . ., . ., . ., . .
, , ,
: .
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- , , - . - - - , . -, - , , , - . - 2,0 3,0.
. 8 , 2 , 2- . 3 -
-
, 2013; 12 ()70
164-166
, . - . .
, - . - - .
164
. ., . ., . ., . ., ., . ., . .
, , ,
() . 504 , 1 - , 31% (157 ). 626,8 , , , 548,9 . 136 (87%) - ,
36 (23%) . 222 (64%) 48 (14%) . 96 (28%) 25 (25%). , , - , -, .
- , , -. . , , , - . , , . - . , , . , . . - ST , . - . , , . .
- . () - 52% , 29%. - , .
, , -.
165
. ., . ., . ., . ., . .
, ,
. .
. 32 - , - II$5II , 4373 ( 58,4+/- 9,31). 14 . - Toshiba, 0,5 -
370 80 . - Philips Integris Allura - . - . 50%. 384 , 24 - .
. 104 (28,9%) 360 . 96 (26,7%) .
256 (71,1%) , 238 (66,1%) .
14 (3,9%) , - , ; 12 (3,3%) - - -.
- .
. . .
166 -
. ., . ., . . -
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: 44 - 19 35 2 . , Tei. 2 : 1 (n=21) - () - II ., 2 (n=23) -
.
-
, 2013; 12 () 71
167-168
. - , 38,1% 1 - - , 4,3% (
-
, 2013; 12 ()72
169-170
17% , ), . - 50% - . - , .
: , - -. , 50 / 2 2005 .
169
. ., . ., . ., . .
, ,
: .
: , - 430 (174 - 256 ) 20 79 ( 51,40,6 ) , - . , () . : , 25
29,9 / 2; - I , 30 34,9 / 2; - II , 35 39,9 / 2; - III : 40 49,9 /
2 - 50 / 2. -. (/), (, , , \). - , -.
: . , I 8% 11% (0,01). II 9% 12% (0,01). 4050 / 2 12% (0,01) (6%
0,05). 50 / 2
22% (0,01) - (7% 0,05). , -. 50 / 2 25% .
: , ( -
) 820%, -. , - , , . , -.
170 -
. . 1, . . 1, . . 1, . . 2
1 , , ; 2 , ,
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. 89 (89 , 53,70,73 ), 60 29 - .
- ( 16 - ).
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: (s, /), (e, /) (a, /) - e/a.
2. - ( strain,%) .
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. ( 162 ) : 1. : s (/) (5,340,19 5,10,21 p
-
, 2013; 12 () 73
171-173
. . -- .
171
- .., . ., . ., . ., . .
52 , ,
. () () ().
. - 253 , - , . 156 . 97 , , . . : - -, . - . --.
. -- , 70,97,3 59,08,7 (
-
, 2013; 12 ()74
174-175
: , - ( - 1- II) 12 .
. , - , () 90109 .., () 179 .., () - >135/85 .. , - . , . -
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3 . 6 .
. - ( 6,6%) ( 6,7%), ( 20,1%) ( 32,4%). - , , , . - .
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