NON-SPECIFIC ADAPTIVE REACTIONS IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION (STEMI) AT DIFFERENT BODY WEIGHTS

N. Lutsiv, V. Akimova, O. Labinska, M. P. Halkevich, N. R. Demyanchuk, M. Shchurko, L. P. Kostiuk
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Abstract

three research groups (79 patients) were analyzed: Group I - 28 patients with STEMI and normal body weight, Group II - 24 patients with STEMI and excess body weight, and Group III - 27 patients with STEMI and obesity of the I-III degrees. The diagnosis (acute coronary syndrome) of ACS was made based on a complex clinical, laboratory and instrumental examination. Blood was taken for the study when patients were admitted to the department. The total number of leukocytes and the leukocyte blood formula were determined by standardized methods; the type of non-specific adaptation reaction - according to the method of L.H. Harkavi; the ratio of the absolute content of neutrophils to the absolute content of lymphocytes (neutrophil to lymphocyte ratio, NLR), and the ratio of the absolute content of neutrophils to the absolute content of platelets (neutrophil to platelet ratio, NPR) was determined. The course of ACS occurs against the background of several non-specific adaptation reactions, where the stress reaction was dominant (42.8% - group I, 50% - group II, and 51.9% - group III), indicating the disease's severity. The highest level of NLR (p<0.05) was found in group III, relative to the NLR indicator in group I and group II, and the highest level of NPR was found in group III precisely in case of a stress reaction, which indicates an unfavourable prognosis for patients of this group. Determining the type of nonspecific adaptation reaction can serve as an additional indicator of the severity of the patient and allows us to assess the effectiveness of therapy in patients with STEMI. The indicators of NLR and NPR were useful and powerful indicators of adverse consequences during the hospitalization of patients with ACS. The type of adaptive response and the indicators of NLR and NPR are determined based on clinical blood analysis indicators, and they are economical biomarkers for predicting the severity of inflammation.
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不同体重急性冠状动脉综合征st段抬高患者的非特异性适应反应
分析三个研究组(79例):I组- 28例STEMI伴正常体重,II组- 24例STEMI伴超重体重,III组- 27例STEMI伴I-III度肥胖。ACS的诊断(急性冠脉综合征)是基于复杂的临床、实验室和仪器检查。当病人被送进该部门时,研究人员为这项研究采血。采用标准化方法测定白细胞总数和白细胞血方;非特异性适应反应的类型——根据L.H. Harkavi的方法;测定中性粒细胞绝对含量与淋巴细胞绝对含量之比(neutrophil to lymphocyte ratio, NLR)和中性粒细胞绝对含量与血小板绝对含量之比(neutrophil to platelet ratio, NPR)。ACS的病程发生在几种非特异性适应反应的背景下,其中应激反应占主导地位(42.8% - I组,50% - II组,51.9% - III组),表明疾病的严重程度。ⅲ组NLR相对于ⅰ组和ⅱ组NLR指标最高(p<0.05),而ⅲ组正是在应激反应时才出现NPR的最高水平,提示该组患者预后不良。确定非特异性适应反应的类型可以作为患者严重程度的附加指标,并使我们能够评估STEMI患者治疗的有效性。NLR和NPR指标是ACS患者住院期间不良后果的有用且有力的指标。NLR和NPR是根据临床血液分析指标确定的适应性反应类型和指标,是预测炎症严重程度的经济生物标志物。
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