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1. Артерiальна гiпертензiя. Оновлена та адаптована клтачна настанова, заснована на доказах / Асощащя кардюлопв Укра!ни. - К., - 2012. - 139 с.
2. Дмитриев В. А. Неспецифическое воспаление и структурные изменения артерий у мужчин с гипертонической болезнью среднего и высокого риска развития сердечно-сосудистых осложнений / В. А. Дмитриев, Е. Ощепкова, В. Титов [и др.] // Терапевтический архив. - 2012. - №. 9. - С. 53-57.
3. Iшемiчна хвороба серця:стабшьна стенокардiя напруги / Наказ МОЗ Украши № 816 вщ 23 листопада 2011 року // Практикуючий лжар. - 2012. - №1. - С.84-89.
4. Оренко Ю. М. Медико-сощальш проблеми кардюлопчно! допомоги в Укра!ш: шляхи виршення / Ю.М. Оренко // Проблеми безперервно! медично! осв™ та науки. - 2014. - №. 2. - С. 6-10.
5. Bautista L. E. Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-alpha) and essential hypertension / L. E. Bautista, L. M. Vera, I. A. Arenas [et al.] // J. Hum. Hypertens. - 2005. - Vol. 19. - P. 149-154.
6. Duprez D. A. Association of Small Artery Elasticity With Incident Cardiovascular Disease in Older Adults The Multi-Ethnic Study of Atherosclerosis / D. A. Duprez, D. R. Jacobs, P. L. Lutsey [et al.] // American journal of epidemiology - 2011,Vol. 174, P. 528-536.
7. Harrison D. G. Inflammation, immunity, and hypertension / D.G. Harrison, T.J. Guzik, H.E. Lob [et al.] // Hypertension. -2011. - Vol. 57(2). - P. 132-140.
8. Schillaci G. Increased C-reactive protein concentrations in never-treated hypertension: the role of systolic and pulse pressures / G. Schillaci, M. Pirro, F. Gemelli [et al.] // J Hypertens. - 2003. - Vol. 21. - P. 1841-1846.
9. Touboul P. J. Mannheim Carotid Intima-Media Thickness Consensus (2004-2006) / P.J. Touboul, M.G. Hennerici, S. Meairs [et al.] // Cerebrovasc Dis. - 2007, Vol. 23. - P. 75-80.
ОСОБЕННОСТИ РЕМОДЕЛИРОВАНИЯ СОСУДОВ И МАРКЕРЫ ИММУНО-ВОСПАЛИТЕЛЬНОГО ОТВЕТА У БОЛЬНЫХ ГБ II СТАДИИ Фуштей И. М., Моченый В. А.
Клиническое и патогенетическое значение иммуно-воспалительного ответа в возникновении ишемической болезни сердца (ИБС) у больных гипертонической болезнью (ГБ) изучены недостаточно. Для определения степени ремоделирования сосудов (РС) и его взаимосвязи с концентрацией иммуно-воспалительных маркеров в плазме крови проведено комплексное исследования 180 больных гипертонической болезнью (ГБ) II стадии. Установлено, что скорость распространения пульсовой волны (СРПВ) на аорто-бедренном сегменте (АБС) была наивысшей при сочетании ИБС и ГБ (11,4 ± 0,5 м/с против 10,1±0,2 м/с у пациентов с ГБ без ИБС, р <0,05). Выявлена достоверная прямая связь средней силы (Б=+0,31, р=0,0004) между уровнем интерлейкина-1р и толщиной комплекса интима-медиа дистального сегмента общей сонной артерии, а также между СРПВ по АБС и интерлейкином-1 в (Я = + 0,23, р = 0,01).
Ключевые слова: гипертоническая болезнь, ишемическая болезнь сердца, ремоделирование сосудов, иммуно-воспалительные маркеры.
Стаття надшшла 5.09.2015 р.
FEATURES VASCULAR REMODELING AND MARKERS OF IMMUNE-INFLAMMATORY RESPONSE IN PATIENTS WITH EH STAGE II Fushtey I. M., Mochonyi V. A.
Clinical and pathogenetic significance of immuno-inflammatory response in the occurrence of coronary heart disease (CHD) in patients with essential hypertension (EH) is insufficiently studied. To determine the degree of vascular remodeling (MS) and its relationship with the concentration of immuno-inflammatory markers in blood plasma is a complex clinical and paraclinical study of 180 patients with essential hypertension (EH) II stage. Established that the velocity of the pulse wave (SHRPH) in aorto-femoral segment (ACC) was highest when combined CHD and GC (11,4 ± 0,5 m / s to 10,1 ± 0,2 m / s in patients with EH without CHD, p <0,05). Found a reliable direct communication medium strength (R = + 0,31, p = 0,0004) between the level of IL-1P and thickness of intima-media distal segment of the common carotid artery and between SHRPH by ACC and interleukin-1p ( R = + 0,23, p = 0,01).
Key words: hypertension, coronary heart disease, vascular remodeling, immuno-inflammatory markers.
Рецензент Катеренчук I.П.
UDC 616.314.18-002.4.-085.272.4:616.316-008.8-078:577.125.33
MALONDIALDEHYDE LEVELS AND ACTIVITY OF SUPEROXIDE DISMUTASE IN THE ORAL FLUID OF PATIENTS WITH CHRONIC GENERALIZED PERIODONTITIS
The research in question demonstrates pathogenetic role of abnormal processes of lipid peroxidation and antioxidant defense in the oral fluid in their connection with clinical change in development of chronic generalized periodontitis of I-II degree of severity. High therapeutic efficiency of the lipoflavon was shown to be determined by antioxidant, membranotropic, anti-inflammatory effects.
Key words: malondialdehyde, lipid peroxidation, superoxide dismutase, antioxidant activity, chronic generalized periodontitis, pathogenesis, lipoflavon.
Chronic generalized periodontitis (CGP) is an oral inflammatory disorder that gives rise to tissue damage and loss, as a result of the complex interaction between pathogenic bacteria and the host's immune response [3]. Evidence has been accumulated which suggest that oxygen derived free radicals (FR) and their products play an important role in pathogenesis of chronic inflammatory disorder like periodontitis. Free radicals may be defined as any species capable of independent existence that contains
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one or more unpaired electrons. Prime targets of reactive oxygen species (ROS) are polyunsaturated fatty acids (PUFA) in membrane lipids causing lipid peroxidation. Malondialdehyde (MDA) is formed by peroxidation of PUFA and is used as a measure of lipid peroxidation (LPX) [8]. The living organism has adapted itself to an existence under a continuous efflux of free radicals. Among the different adaptive mechanisms, the antioxidant defense mechanisms are of major importance. Antioxidants are those substances which when present in lower concentration compared to that of an oxidisable substrate, will significantly delay or inhibit oxidation of that substance. The antioxidants like vitamin E, vitamin C, ceruloplasmin, quercetin, glutathione peroxidase and superoxide dismutase (SOD) protect tissue damage induced by free radicals [2, 4].
Efficiency of local application of medical drugs in periodontal tissues depends on the exposition of substances in the periodontal pocket (PP), choice of medical substances, method of their application, contact with oral mucosa and its concentration. Therefore it is necessary advantage to give to the forms and pathways of medications with the controlled and long action [10, 11]. Development and application of highly effective and safe methods of drug therapy for chronic generalized periodontitis (CGP) has been legally considered one of priority directions of native and foreign researchers [12, 13, 14]. Medical local therapy is inalienable part of complex treatment for CGP [9].
Liposomes, owing to their small size, penetrate the regions that may be inaccessible to other delivery systems. It is noteworthy that only liposomes have been largely exploited for drug delivery because the methods of preparation are generally simple and easy to scale-up. The aim of using liposomal carriers is generally, to increase the specificity towards cells or tissues, to improve the bioavailability of drugs by increasing their diffusion through biological membranes, to protect them against enzyme inactivation. These systems reduce the frequency of administration, further provide a uniform distribution of the active agent over an extended period of time [5, 7].
Anti-inflammatory properties of «Lipoflavon» (JSC «Biolek», Kharkiv, Ukraine), containing lecithin liposomes and quercetin are conditioned by its expressed anti-leukotrienes activity. Quercetin inhibits production of inflammation-producing enzyme 5-lipoxygenase.
The aim of this study is to measure lipid peroxidation (MDA as an end product of oxidative stress) and corresponding antioxidant activity (SOD) in patients with CGP of I-II degree of severity and assess the influence of periodontal treatment with gel from the Granules of Quercetin (GQ) and Liposomal Quercetin-Lecithin Complex (LQLC) on these parameters.
Material and Methods. Thirty five patients with CGP of I-II degree of severity were observed. In accordance to treatment all patients were divided into 2 groups: group 1 - basic treatment with local application of LQLC (20 patients) with using of individual periodontal delivery tray; group 2 (group of comparison) - basic treatment with local application of gel from GQ (18 patients) with using of individual periodontal delivery tray. The control group (C) included 14 healthy subjects without systemic inflammatory diseases.
The patients of the basic group were administered base therapy with local application of LQLC (injection form of «Lipoflavon») as a suspension, prepared ex tempore, containing 137.5 mgs of Lecithin and 3.75 mgs of Quercetin. This suspension prepared at a premix 1/4 parts of content of small bottle with 5 ml 0.9% solution of natrium chloride, warmed up to 380 C. The patients of the comparison group were administered base therapy with local application of gel from GQ using individual periodontal delivery tray for 40 minutes 2 times per day for 12 days.
All observed patients in the morning were conducted of oral fluid (OF) before treatment and through 1, 6 and 12 months after treatment for lipid peroxidation and antioxidant activity researches. Six months later the patients were examined, was inspected and was conducted supporting therapy the condition of periodontal tissues, which included the professional hygiene of oral cavity and local treatment using individual periodontal delivery tray with gel from GQ and LQLC during 12 days for 40 minutes 2 times per day, and also reception inward during 1 month of 1 g «GQ» 2 times per day.
Results and discussion. The patients of control group were measured in OF: MDA - 4.62±0.23 ^mol/l and SOD - 4.73±0.11 c.u./l. Imbalance between oxidative stress and antioxidant capacity may play a role in the pathogenesis of periodontal disease. Non-surgical periodontal treatment leads to a reduction of MDA and to levels comparable to healthy controls. ROS cause toxic effects by oxidative damage to macromolecules such as proteins, lipids and nucleic acids. The present study revealed extensive increase of MDA in the both groups of periodontitis resulting from concomitant increase in ROS production. Thus, large amounts of pro-oxidants are produced in prolonged inflammatory response as seen in periodontitis.
Antioxidants protect structural and tissue integrity by counteracting the harmful effect of FR. Imbalances between FR and antioxidants have been suggested to play an important role in the onset and development of several inflammatory oral diseases, e.g. periodontitis. Antioxidant enzymes provide protection against oxidative injury from oxygen FR [1, 6]. SOD is an antioxidant enzyme that catalyses the dismutation of the highly reactive superoxide anion to O2 and to the less reactive species H2O2, accelerating it up to 10,000 times. 2O2°- + 2H+ ^ H2O2 + O2.
OF were measured in patients with I-II degree of severity in the basic group: MDA - 7.05 ± 0.49 ^mol/l, that was higher than 53 % in group C (p < 0.001); SOD - 3.76 ± 0.2 c.u./l, that was lower than 21 % in group C (p < 0.05). The patients in the comparison group before treatment were examined for MDA
- 7.11 ± 0.52 ^mol/l, that was over than 54 % in group C (p < 0.001); SOD was 3.81 ± 0.19 c.u./l, that was lower 19 % in group C (p < 0.001).
The patients with I-II degree of severity in the basic group after treatment 1 month later were measured OF: MDA - 4.23 ± 0.79 ^mol/l, that was higher than 8 % in group C (p > 0.05); SOD - 5.18 ± 0.16 c.u./l, that were significantly higher in periodontitis patients compared to controls over 5 % (p > 0.05). The patients in the comparison group after treatment 1 month later were measured OF: MDA -5.14 ± 0.48 ^mol/l, that over than 11 % in group C (p > 0.05); SOD - 4.98 ± 0.22 c.u./l; that was lower than 5 % in group C (p > 0.05). The patients with I-II degree of severity in the basic group after treatment 6 months later were measured OF: MDA - 4.79 ± 0,43 ^mol/l, that was over 13 % in group C (p > 0,05); SOD - 5.12 ± 0.17 c.u./l, that was upper than 8 % in group C. The patients in the comparison group after treatment 6 months later were measured in OF: MDA - 4.94 ± 0.6 ^mol/l, that was upper than 4 % in group C; SOD - 4.88 ± 0.17 c.u./l, that was over 3 % in group C (p > 0.05). The patients with I-II degree of severity in the basic group after treatment 12 months later were measured OF: MDA - 4,81 ± 0,36 ^mol/l, that was 4 % higher in group C (p > 0.05); SOD - 5.04 ± 0.16 c.u./l, that was upper than 7 % in group C. The patients in the comparison group after treatment 12 months later were measured OF: MDA
- 5.18 ± 0.48 ^mol/l, that was lower than 12 % in group C; SOD - 4.82 ± 0.17 c.u./l, that was higher than 2 % in group C (p > 0.05).
The research in question demonstrates pathogenetic role of abnormal processes of lipid peroxidation and antioxidant protection in the OF in their connection with clinical change in development of CGP with I-II degree of severity. The scheme of complex treatment of periodontitis by means of local application of lipoflavon using individual periodontal polyvinylchloride delivery tray contributing to inflammation elimination and long-term remission has been developed. High therapeutic efficiency of the LQLC was shown to be determined by antioxidant, membranotropic, anti-inflammatory effects. This allows to recommend lipoflavon for local application as pathogenetically substantiated drug in treatment of generalized periodontitis.
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9. Грудянов А. И. Лекарственные средства, применяемые при заболеваниях пародонта / А. И. Грудянов // -Пародонтология, - 1998. - № 2. - С. 6-17.
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11. Барер Г.М. Терапевтическая стоматология / Г.М. Барер // - Москва, ГЭОТАР-Медиа, - 2008. - Ч.2. Болезни пародонта. - 224 с.
12. Данилевский Н. Ф. Заболевания пародонта / Н. Ф. Данилевский, А. В. Борисенко // Киев: Здоров'я, - 2000. - 462 с.
13. Мащенко И. С. Болезни пародонта. Учебное пособие по терапевтической стоматологии / И. С. Мащенко // Днепропетровск, Коло, - 2003. - 272 с.
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УРОВЕНЬ МАЛОНДИАЛЬДЕГИДА И АКТИВНОСТЬ СУПЕРОКСИДДИСМУТАЗЫ В РОТОВОЙ ЖИДКОСТИ ПАЦИЕНТОВ С ХРОНИЧЕСКИМ ГЕНЕРАЛИЗОВАННЫМ ПАРОДОНТИТОМ Худякова М.Б.
Изучение проблемы демонстрирует патогенетическую роль аномальных процессов перекисного окисления липидов и антиоксидантной защиты в ротовой жидкости в их связи с клиническими изменениями в развитии хронического генерализованного пародонтита 1-11 степени тяжести. Высокая терапевтическая эффективность липофлавона определяется антиоксидантным, мембранотропным, противовоспалительным действием.
Ключевые слова: малондиальдегид, перекисное окисление липидов, супероксиддисмутазы, антиоксидантная активность, хронический генерализованный пародонтит, патогенез, липофлавон.
Стаття надшшла 12.09.2015 р.
Р1ВЕНЬ МАЛОНД1АЛЬДЕГ1ДА ТА АКТИВН1СТЬ СУПЕРОКСИДДИСМУТАЗИ В РОТОВ1Й Р1ДИН1 ПАЩеНТШ З ХРОН1ЧНИМ ГЕНЕРАЛ1ЗОВАНИМ ПАРОДОНТИТОМ Худякова М.Б.
Дослщження ппроблеми демонструе патогенетичну роль аномальних процеав перекисного окислення лiпiдiв та антиоксидантного захисту в ротовш рiдинi в !х зв'язку з клшчно! змши у розвитку хронiчного генералiзованого пародонтиту 1-11 ступеня тяжкоси. Висока терапевтична ефектившсть лiпофлавону визначаеться антиоксидантною, мембранотропною, протизапальною дiею.
Ключовi слова: малондiальдегiд, перекисне окислення лшвдв, супероксиддисмутази,
антиоксидантна активнiсть, хронiчний генералiзований пародонтит, патогенез, лiпофлавон.
Рецензент Петрушанко Т.О.
УДК 618.14-005.1-055.25
ШШШШШШ1
тшшшшшш
МОДЕЛЮВАННЯ МОЖЛИВОСТ1 ВИНИКНЕННЯ ПУБЕРТАТНИХ МАТКОВИХ КРОВОТЕЧ У Д1ВЧАТ В ЗАЛЕЖНОСТ1 В1Д ОСОБЛИВОСТЕЙ СОНОГРАФ1ЧНИХ
ПАРАМЕТР1В МАТКИ I ЯеЧНИК1В
В роботi, на основi особливостей сонографiчних параметрiв матки i яечниюв та гормонального фону в рiзнi фази менструального циклу, використовуючи метод покрокового дискримiнантного аналiзу, у дiвчат вiком вiд 14 до 18 роюв побудованi високошформативш достовiрнi моделi можливостi виникнення пубертатних маткових кровотеч як в загальнш груш, так i у дiвчаток 14-15 рокiв та дiвчат 16-18 роюв. Найбшьший внесок у дискримшащю, незалежно вiд вiкових груп, найбшьш часто вносить товщина ендометрiю в фолкулшову фазу циклу.
Ключовi слова: пубертатш матковi кровотечi, сонографiя матки i яечникiв, гормональний фон, дискримшантш моделi.
Робота е фагментом НДР "Розробити моделi прогнозування пубертатних маткових кровотеч та альгодисменореI у дiвчат в залежностi вiд конститущональних особливостей оргашзму " (№ державноI реестраци: 0115и001168).
На думку бшьшосп втизняних { заруб1жних дослщниюв дисфункцюнальш матков! кровотеч! в пубертатному перюд! вщображають ф!зюлопчну незршсть { недосконалють мехашзм!в регуляцй репродуктивно! системи в перюд И дозр1вання [1, 3, 7]. В основ! патогенезу дисфункцюнальних маткових кровотеч у шдл^ковому { юнацькому вщ! лежить гормональний дисбаланс на тт вшово! неспроможност нервово-рецепторного апарату оргашв-мшеней.
Осюльки функцюнальш порушення репродуктивно! функцй починають формуватися саме в пубертатному перюд!, то 1 доцшьним е вивчення репродуктивного потенщалу д1вчат з пубертатними кровотечами та розробка комплексно! системи шдивщуальних параметр!в матки, яечник!в та гормонального фону, як! сприятимуть збереженню репродуктивного потенщалу майбутшх покол!нь.
Метою роботи було побудувати дискримшантш модел! для прогнозування ризику розвитку пубертатних маткових кровотеч у д!вчат в залежност вщ особливостей сонограф!чних параметр!в матки ! яечник!в та гормонального фону в р!зш фази менструального циклу.
Матер1ал та методи дослщження. Первинш сонограф!чн! параметри матки ! яечниюв, а також гормонального фону в фолшулшову (ФФ) ! люте!нову (ЛФ) фази менструального циклу у 113 здорових д!вчаток в!ком в!д 14 до 15 роюв та 121 д!вчини вшом в!д 16 до 18 роюв взят! з банку
