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    Pertseva N. O.

    CHANGES IN THE RELATIONSHIP BETWEEN THE DEGREE OF ENDOTHELIAL FUNCTION DAMAGE AND PLATELET HEMOSTASIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS WITH INSUFFICIENT COMPENSATION AFTER THE TREATMENT OF HYPERTENSION WITH ANGIOTENSIN II RECEPTOR ANTAGONISTS


    About the author: Pertseva N. O.
    Heading CLINICAL MEDICINE
    Type of article Scentific article
    Annotation Background. Many questions about the relationship between endo-thelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hyperten-sion require clarification and further advance. The aim of research. The aim of this study is to determine the rela-tionships between endothelial dysfunction, the degree of renal function dam-age, lipidemic profile and morphological changes of vascular-platelet hemo-stasis in patients with insufficient compensation of type 2 diabetes mellitus and arterial hypertension during 1 year of antihypertensive therapy. Materials and methods. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correla-tional analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological chang-es of vascular-platelet hemostasis during 1 year of antihypertensive therapy. Results. It has been established that significant strengthening relation-ships between indicators of endothelial dysfunction and damaged platelet hemostasis formed significant correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes. Elevated levels of endothelial dysfunction markers were in close correlation due to the majority of ultrastructural parameters of vascular-platelet hemostasis. Patients of this contingent greatest strength of reliable linear correlations observed in pairs: endothelin-1 and aggregated platelets (r=+0.83), endothelin-1 and degranulated platelets (r=+0.88), von Willebrand factor and activated platelets (r=+0.79), thrombomodulin and activated platelets (r=+0.81), thrombomodulin and small platelet aggregates (r=+0.79). The indicators of renal function set the following structure correlation with morphological parameters of platelets, observed a direct correlation with the level of albuminuria proportion of activated (r=+0.75; p<0.05) and aggregated platelets (r=+0.66; p<0.05), and low platelet aggregates content (r=+0.56; p<0.05). Mounted on the strength of moderate inverse correlation with the content of non-activated forms (r=+0.53; p<0.05) and a direct rela-tionship with the concentration of degranulated cells (r=+0.61; p<0.05). Signs of atherogenic dyslipidemia triad that this contingent of patients indicated significant deviation from that of the control group not only had a correlation with the share of activated platelets and content of alpha and del-ta granules, but also formed a new moderate strength correlations with other observable parameters of platelet morphology. In particular, amid insuffi-cient glycemic compensation formed reliable values of the coefficients of lin-ear correlation in pairs: total cholesterol and activated platelets (r=-0.54), low density lipoprotein cholesterol and activated platelets (r=-0.51), low density lipoprotein cholesterol and aggregated forms (r=+0.59), low density lipoprotein cholesterol and degranulated platelets (r=+0.48). Also triglycer-ides level in these patients established statistically significant correlation with all studied parameters of intravascular platelet activation. Conclusion. Density of correlation between morphological parameters of platelet hemostasis and markers of endothelial dysfunction significantly decreases the accuracy or loses after 1 year of antihypertensive therapy. Pro-longed use of angiotensin II receptor antagonists shows a more prominent clinical effectiveness compared with standard antihypertensive therapy.
    Tags diabetes mellitus type 2, hypertension, endothelial dysfunction, platelet hemostasis, correlation
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    Publication of the article «World of Medicine and Biology» №1(48), 2015 year, 058-063 pages, index UDK 616.155.1-008.64:616.1-06