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Risks of adverse outcomes and neonatal morbidity in pregnant women with SARS-CoV-2 depending on the trimester of infection 感染 SARS-CoV-2 的孕妇出现不良后果和新生儿发病率的风险取决于感染的三个月
Pub Date : 2024-03-27 DOI: 10.36604/1998-5029-2024-91-90-97
I. V. Zhukovets, I. Andrievskaya, N. A. Krivoshchekova, K. S. Lyazgiyan, A. N. Narkevich
Introduction. COVID-19 in pregnant women adversely affects the course of the disease, pregnancy outcomes, and morbidity in newborns. However, studies on the impact of the gestational age at which SARS-CoV-2 infection occurs on the risk of neonatal morbidity are lacking.Aim. To assess the risks of adverse pregnancy outcomes and neonatal morbidity in newborns depending on the gestational age at which women were infected with SARS-CoV-2.Materials and methods. The study included 215 women infected with SARS-CoV-2 in the first, second, and third trimesters of pregnancy and 50 uninfected pregnant women. Newborns formed corresponding groups. Data for analysis (general clinical, anamnestic, childbirth outcomes, and newborn condition) were obtained from the records of pregnant, laboring, and postpartum women.Results. In 4.7% of women infected in the first trimester, pregnancy was accompanied by spontaneous miscarriage and in 1.9% by ectopic pregnancy development. In 1.9% of women infected in the second trimester, antenatal fetal demise in a full-term pregnancy was detected. Patients infected with SARS-CoV-2 more often underwent cesarean section (31.7%). The median weight and height of newborns from mothers infected with SARS-CoV-2 were lower than in the control group. The Apgar score at the first minute showed no differences, but at the fifth minute, it was lower than in the control group. Newborns from mothers infected with SARS-CoV-2 were more frequently diagnosed with cerebral ischemia (26.3%), motor disorder syndrome (20.7%), and persistent fetal circulation (27.8%). Only in newborns from mothers with SARS-CoV-2 were hypertensive syndrome (13.1%), posthypoxic cardiomyopathy (13.1%), and intraventricular hemorrhages (10.1%) detected. The Apgar score at the first minute in newborns from mothers infected with SARS-CoV-2 in the third trimester of pregnancy was higher compared to infections in the second trimester. Neonatal morbidity in this cohort of newborns was characterized by a high frequency of cerebral ischemia, motor disorder syndrome, hypertensive syndrome, and persistent fetal circulation. Infection in the third trimester increased the risk of neonatal morbidity: cerebral ischemia by 5.6 times, motor disorder syndrome by 13.78 times, hypertensive syndrome by 8.61 times, and persistent fetal circulation by 2.76 times.Conclusion. COVID-19 during pregnancy increases the risks of adverse outcomes and the development of neonatal pathology in newborns. The frequency of their development is associated with the gestational age at which women were infected. Infection of women with SARS-CoV-2 in the first and second trimesters of pregnancy increases the risk of spontaneous miscarriage and antenatal fetal death, in the third trimester – the development of intraventricular hemorrhages and posthypoxic cardiomyopathy in newborns.
导言。孕妇感染 COVID-19 会对病程、妊娠结局和新生儿发病率产生不利影响。然而,关于感染 SARS-CoV-2 的胎龄对新生儿发病风险的影响还缺乏研究。目的:根据妇女感染 SARS-CoV-2 的胎龄,评估不良妊娠结局和新生儿发病率的风险。研究对象包括 215 名在妊娠第一、第二和第三孕期感染 SARS-CoV-2 的妇女和 50 名未受感染的孕妇。新生儿组成相应的组别。用于分析的数据(一般临床、产程、分娩结果和新生儿状况)来自孕妇、产妇和产后妇女的记录。在头三个月感染的妇女中,4.7%的人怀孕后自然流产,1.9%的人出现宫外孕。在后三个月受感染的妇女中,有 1.9% 的足月孕妇在产前发现胎儿死亡。感染 SARS-CoV-2 的患者更常进行剖腹产(31.7%)。感染 SARS-CoV-2 的母亲所生新生儿的体重和身高中位数均低于对照组。第一分钟的阿普加评分没有差异,但第五分钟的评分低于对照组。感染 SARS-CoV-2 的母亲所生的新生儿被诊断为脑缺血(26.3%)、运动障碍综合征(20.7%)和持续性胎儿循环(27.8%)的比例较高。只有在 SARS-CoV-2 母亲所生的新生儿中,才发现了高血压综合征(13.1%)、缺氧后心肌病(13.1%)和脑室内出血(10.1%)。与怀孕后三个月感染 SARS-CoV-2 的母亲相比,怀孕后三个月感染 SARS-CoV-2 的母亲所生新生儿在第一分钟的 Apgar 评分较高。这组新生儿的发病特点是脑缺血、运动障碍综合征、高血压综合征和胎儿循环持续障碍的发生率较高。妊娠三个月内感染会增加新生儿发病风险:脑缺血增加 5.6 倍,运动障碍综合征增加 13.78 倍,高血压综合征增加 8.61 倍,胎儿持续循环增加 2.76 倍。妊娠期间使用 COVID-19 会增加新生儿出现不良结局和新生儿病变的风险。其发病率与妇女感染的胎龄有关。妇女在妊娠头三个月和后三个月感染 SARS-CoV-2 会增加自然流产和产前胎儿死亡的风险,在妊娠后三个月则会增加新生儿发生脑室内出血和缺氧后心肌病的风险。
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引用次数: 0
Oxidative modification products of lipids in the intraocular fluid of patients with cataracts associated with chronic non-infectious diseases 与慢性非传染性疾病相关的白内障患者眼内液中脂类的氧化修饰产物
Pub Date : 2024-03-23 DOI: 10.36604/1998-5029-2024-91-106-112
M. A. Petrenko, E. A. Borodin
Introduction. To clarify the role of oxidative stress in the development of cataracts, it is necessary to determine the content of oxidative modification products directly in the eye tissue, but such studies are scarce, which is due to the difficulty of obtaining a sufficient amount of biomaterial for analysis and the need to use highly sensitive research methods as a result. Therefore, to assess the pathological changes in the lens, intraocular or tear fluid is used.Aim. To elucidate the role of oxidative stress in the development of cataracts by determining the content of lipid oxidation products and their comparative characteristics in intraocular fluid and in blood plasma in patients with cataracts associated with chronic non-infectious diseases.Materials and methods. The study involved 83 patients with cataracts associated with non-infectious diseases, who underwent surgical treatment. Of these, 30 patients had chronic obstructive pulmonary disease (COPD) as a comorbid condition, 45 had cardiovascular diseases (CVD), and 13 had diabetes mellitus (DM). The control group consisted of 30 practically healthy individuals without clinical signs of acute or chronic diseases. Lipid oxidation products were determined by ultraviolet spectroscopy. Absorption spectra of non-oxidized lipids (E204), diene conjugates (E233), conjugated trienes, and ketodiene (E278) were recorded. Additionally, the ratios of absorption spectra of diene conjugates to non-oxidized lipids (E233/E204), as well as conjugated dienes and ketodienes to non-oxidized lipids (E278/E204), were calculated. Tear and intraocular fluids, as well as blood plasma, served as materials for the study.Results. In the group of patients with cataracts associated with non-infectious diseases, the content of diene conjugates, conjugated trienes, and ketodienes was increased relative to similar indicators in the tear fluid of people in the control group. Moreover, more pronounced changes were observed in the group of patients with cataracts associated with COPD relative to those with CVD and DM. A comparative analysis confirmed that in the group of patients with cataracts associated with COPD, the content of oxidized lipids in intraocular fluid and in blood plasma was increased. Correlation-regression analysis showed a positive relationship between the indicators of diene conjugates in intraocular fluid and in blood plasma.Conclusions. The significant direct linear relationship between the indicators of oxidized lipids in intraocular fluid and in blood plasma in patients with cataracts and non-infectious diseases may indicate the possibility of using blood plasma for studying oxidative processes in the lens and its pathological changes for the purpose of selecting therapy and evaluating treatment efficacy. The results obtained confirm the role of oxidative stress in the development of cataracts in patients with chronic non-infectious diseases.
导言。为了明确氧化应激在白内障发病过程中的作用,有必要直接测定眼组织中氧化修饰产物的含量,但此类研究很少,原因是难以获得足量的生物材料进行分析,因此需要使用高灵敏度的研究方法。因此,要评估晶状体的病理变化,需要使用眼内液或泪液。通过测定与慢性非感染性疾病相关的白内障患者眼内液和血浆中脂质氧化产物的含量及其比较特征,阐明氧化应激在白内障发病过程中的作用。研究涉及 83 名接受手术治疗的非感染性白内障患者。其中,30 名患者合并慢性阻塞性肺病(COPD),45 名合并心血管疾病(CVD),13 名合并糖尿病(DM)。对照组由 30 名身体健康、无急慢性疾病临床表现的人组成。脂质氧化产物通过紫外光谱进行测定。记录了非氧化脂质(E204)、二烯共轭物(E233)、共轭三烯和酮二烯(E278)的吸收光谱。此外,还计算了二烯共轭物与未氧化脂质的吸收光谱比(E233/E204),以及共轭二烯和酮二烯与未氧化脂质的吸收光谱比(E278/E204)。研究以泪液、眼内液和血浆为材料。在与非感染性疾病相关的白内障患者组中,与对照组泪液中的类似指标相比,二烯共轭物、共轭三烯和酮二烯的含量有所增加。此外,在与慢性阻塞性肺病相关的白内障患者组中,与心血管疾病和糖尿病患者组相比,观察到了更明显的变化。对比分析证实,在与慢性阻塞性肺病相关的白内障患者组中,眼内液和血浆中氧化脂质的含量都有所增加。相关回归分析表明,眼内液和血浆中的二烯共轭物指标之间存在正相关关系。白内障和非感染性疾病患者眼内液和血浆中的氧化脂质指标之间存在明显的直接线性关系,这表明可以利用血浆研究晶状体的氧化过程及其病理变化,以选择治疗方法和评估治疗效果。研究结果证实了氧化应激在慢性非感染性疾病患者白内障发病过程中的作用。
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引用次数: 0
Family case of cystic fibrosis 囊性纤维化家庭病例
Pub Date : 2024-03-23 DOI: 10.36604/1998-5029-2024-91-113-122
D. A. Sharafutdinova, R. F. Gatiyatullin, D. S. Valeeva, E. Bogomolova, R. Gafurova, L. E. Burangulova, E. R. Magafurova
Cystic fibrosis is an autosomal recessively inherited monogenic disease caused by a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, located on the long arm of chromosome 7 (7q31.2). This mutation results in a disruption in the transport of sodium and chloride ions between intercellular fluid and the epithelial cells of the excretory ducts of the exocrine glands. This paper presents the description of a family case of cystic fibrosis involving two patients who have been under observation since birth and are sisters (patient A – 4 years 10 months, patient B – 1 year 11 months). In both patients, neonatal screening and sequential diagnosis of cystic fibrosis identified the DF508/CFTRdele2.3(21kb) mutation, the most prevalent among the Caucasian population in the Russian Federation. The primary concern in managing both patients is the correction of nutritional status and minimization of exacerbations of chronic bronchopulmonary inflammation. To determine the management strategy for these patients, a consultation was held with Dr. E.I. Kondratyeva, a leading cystic fibrosis expert and professor at the MGSC Institute, who serves as the head of the Scientific and Clinical Department of Cystic Fibrosis and the Department of Genetics of Respiratory System Diseases, an expert of the European Society for Cystic Fibrosis Committee on Diagnostics and Registry, and Deputy Chief for Scientific Work of Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region. The peculiarity of the presented clinical cases lies in the fact that within one family, with an interval of 3 years, two girls with severe disease were born. Early diagnosis was performed for both, which has allowed for the slowing down of the pathology's progression.
囊性纤维化是一种常染色体隐性遗传的单基因疾病,由位于第 7 号染色体长臂(7q31.2)上的囊性纤维化跨膜传导调节器(CFTR)基因突变引起。该基因突变导致钠离子和氯离子在细胞间液和外分泌腺排泄管上皮细胞之间的转运发生障碍。本文介绍了一个囊性纤维化家族病例,该病例涉及两名自出生以来一直接受观察的患者,她们是姐妹(患者 A - 4 岁 10 个月,患者 B - 1 岁 11 个月)。在对这两名患者进行新生儿筛查和囊性纤维化序列诊断时,发现了 DF508/CFTRdele2.3(21kb)突变,该突变在俄罗斯联邦的高加索人群中最为普遍。治疗这两名患者的首要任务是纠正营养状况,尽量减少慢性支气管肺部炎症的加重。为了确定这些患者的治疗策略,我们与囊性纤维化专家、MGSC 研究所教授 E.I. Kondratyeva 博士进行了磋商,她是囊性纤维化科学与临床部和呼吸系统疾病遗传学部主任、欧洲囊性纤维化学会诊断与登记委员会专家、莫斯科州卫生部儿童临床研究所科研工作副主任。本临床病例的特殊性在于,在一个家庭中,两个患有严重疾病的女孩相隔 3 年才出生。这两个女孩都得到了早期诊断,从而减缓了病情的发展。
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引用次数: 0
The effect of drugs used in the treatment of hemoblastosis on the morphofunctional state of spermatozoa 治疗血崩的药物对精子形态功能状态的影响
Pub Date : 2024-03-23 DOI: 10.36604/1998-5029-2024-91-98-105
E. E. Abramkin, N. V. Menshikova, I. Y. Makarov
Introduction. The relevance of the study is due to the high frequency of complications after the use of drugs for treating malignant tumors, which is associated with the cytotoxic effect of chemotherapy drugs both on malignancy sites and on healthy tissues, including the cells of male gonads.Aim. To study the impact of drugs intended for the treatment of hemoblastoses on the total sperm count, their mobility, and the presence of pathological forms under experimental conditions.Materials and methods. A case-control study was conducted on 18 male rats aged 90 days. The control group consisted of male rats that did not receive hemoblastosis treatment drugs, and the second group was intraperitoneally injected with cyclophosphamide, hydroxydaunorubicin, vincristine, prednisolone (hereinafter referred to as CHOP). Mature spermatozoa were obtained from the dissected appendages of the testes, by opening them on a thermal stage. The contents of the rat's seminiferous tubules, in a volume of 0.02 ml, were diluted in 0.4 ml of 0.9% sodium chloride solution, preheated to 37°C. The total, absolute, and relative number of spermatozoa in a unit volume (0.4 ml) of epididymal suspension was counted, taking into account their mobility according to the generally accepted system. Actively mobile and weakly mobile were attributed to the fertile fraction, and "twitching" and immobile - to the infertile fraction of epididymal spermatozoa. Then, the fertility index was calculated, which represents the ratio of the number of fertile forms to infertile ones. To determine the viability of spermatozoa, their count with regard to mobility was conducted within the first hour every 15 minutes, and subsequently every 30 minutes until the complete cessation of all spermatozoa. To assess the pathological forms of spermatozoa, the absolute and percentage content of spermatozoa in a unit volume (0.4 ml) of epididymal suspension with defects in the head, neck, midpiece, and tail was counted under light microscopy.Results. The experimental exposure to CHOP group drugs had the following effects: a decrease in the total number of spermatozoa by 37% was observed in the male rats of the experimental group, accompanied by an increase in the number of their pathological forms by 26% compared to the control group.Conclusion. The increased risk of infertility, caused by the toxic effect of drugs intended for the treatment of hemoblastoses, is associated with a decrease in the total number of spermatozoa and an increase in pathological forms, leading to a reduction in the number of mobile cells.
引言这项研究之所以具有现实意义,是因为在使用治疗恶性肿瘤的药物后,并发症的发生率很高,这与化疗药物对恶性肿瘤部位和健康组织(包括男性性腺细胞)的细胞毒性作用有关。研究在实验条件下,治疗血液肿瘤的药物对精子总数、活动力和病理形态的影响。对 18 只年龄为 90 天的雄性大鼠进行了病例对照研究。对照组为未接受血崩治疗药物的雄性大鼠,第二组腹腔注射环磷酰胺、羟基达柔比星、长春新碱、泼尼松龙(以下简称 CHOP)。通过在热台上打开睾丸,从解剖的睾丸附属器中获取成熟精子。用 0.4 毫升 0.9%氯化钠溶液稀释大鼠曲细精管的内容物,体积为 0.02 毫升,预热至 37°C。计算单位体积(0.4 毫升)附睾悬液中精子的总数、绝对数和相对数,并根据公认的系统考虑精子的流动性。活动力强和活动力弱的精子属于可育精子,"抽动 "和不活动的精子属于附睾精子中的不可育精子。然后,计算可育指数,该指数代表可育精子与不可育精子数量之比。为了确定精子的存活率,在第一小时内每 15 分钟对精子的活动能力进行一次计数,随后每 30 分钟计数一次,直到所有精子完全停止活动。为了评估精子的病理形态,在单位体积(0.4 毫升)的附睾悬液中,在光镜下计数头部、颈部、中段和尾部有缺陷的精子的绝对含量和百分比。与对照组相比,实验组雄性大鼠的精子总数减少了 37%,病态精子的数量增加了 26%。治疗血崩药物的毒性作用导致不育风险增加,这与精子总数减少和病理形态增加有关,导致活动细胞数量减少。
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引用次数: 0
Characterization of lipid peroxidation processes and antioxidant defense in parturients with COVID-19 COVID-19 孕妇脂质过氧化过程和抗氧化防御的特征
Pub Date : 2024-03-23 DOI: 10.36604/1998-5029-2024-91-84-89
N. A. Ishutina, I. Andrievskaya, N. A. Krivoschekova
Aim. The aim of the study was to investigate the functional state of the «lipid peroxidation - antioxidant defense» system in the peripheral blood of parturients with mild and severe COVID-19.Materials and methods. This casecontrol study examined 95 parturients with confirmed COVID-19 diagnosis in the third trimester, divided into two groups based on the severity of the disease. Group 1a included parturients with severe COVID-19 (community-acquired pneumonia, n=48), while group 1b consisted of patients with mild COVID-19 (acute respiratory viral infection, n=47). The control group was composed of 45 parturients without a prior or current diagnosis of COVID-19. The average age of women in the study groups was 23.9±0.50 years, and 24.4±0.60 years in the control group (p>0.05). Peripheral venous blood served as the material for the study. Spectrophotometric methods were used to examine the concentrations of primary (diene conjugates - DC) and final (active thiobarbituric acid products - TBARS) products of lipoperoxidation. The content of 8-isoprostane, total antioxidant capacity of plasma components, and phospholipase A2 were investigated using enzymelinked immunosorbent assay (ELISA).Results. Study showed that parturients with severe COVID-19 had increased levels of phospholipase A2 by 2.1 times (p<0.001), oxidative stress markers: diene conjugate concentrations by 1.94 times (p><0.001), TBARS by 2.2 times (p><0.001), and 8-isoprostane by more than 2 times (p><0.001), along with a simultaneous decrease in the total antioxidant capacity of blood plasma components by 1.7 times (p><0.001) compared to the control group. In the group of parturients with mild COVID-19, the studied indicators changed less significantly. Conclusion. The study established the pathogenetic role of SARS-CoV-2 in disrupting the functional system of «lipid peroxidation - antioxidant defense» and the development of oxidative stress in parturients who had COVID-19 in the third trimester. A dependency of oxidative stress marker concentrations in peripheral blood on the severity of COVID-19 was identified. It was shown that COVID-19 in the third trimester of pregnancy is associated with high levels of phospholipase A2, an imbalance in the prooxidant-antioxidant system, characterized by a reduction in the level of total antioxidant capacity and an increase in oxidative modification products of biomolecules, expressed by the growth of DC, TBARS, and 8-isoprostane levels, leading to oxidative stress correlated with the severity of lung damage. Key words: COVID-19, parturients, lipid peroxidation, antioxidant defense, oxidative stress> ˂ 0.001), oxidative stress markers: diene conjugate concentrations by 1.94 times (p ˂ 0.001), TBARS by 2.2 times (p ˂ 0.001), and 8-isoprostane by more than 2 times (p ˂ 0.001), along with a simultaneous decrease in the total antioxidant capacity of blood plasma components by 1.7 times (p ˂ 0.001) compared to the control group. In the group of parturient
研究目的本研究旨在调查轻度和重度 COVID-19 孕妇外周血中 "脂质过氧化-抗氧化防御 "系统的功能状态。本病例对照研究共调查了 95 名确诊为 COVID-19 的孕产妇,根据病情严重程度分为两组。1a 组包括患有重度 COVID-19 (社区获得性肺炎,48 人)的产妇,1b 组包括患有轻度 COVID-19 (急性呼吸道病毒感染,47 人)的患者。对照组由 45 名既往未确诊或目前未确诊 COVID-19 的产妇组成。研究组妇女的平均年龄为(23.9±0.50)岁,对照组妇女的平均年龄为(24.4±0.60)岁(P>0.05)。研究材料为外周静脉血。采用分光光度法检测脂肪过氧化的初级产物(二烯共轭物-DC)和最终产物(活性硫代巴比妥酸产物-TBARS)的浓度。使用酶联免疫吸附试验(ELISA)检测了 8-异前列烷的含量、血浆成分的总抗氧化能力和磷脂酶 A2。研究表明,患有严重 COVID-19 的产妇的磷脂酶 A2 水平增加了 2.1 倍(p ˂0.001),氧化应激标记物:二烯共轭物浓度增加了 1.94 倍(p ˂0.001),TBARS 增加了 2.2倍(p ˂0.001),8-异前列腺烷增加了2倍多(p ˂0.001),与对照组相比,血浆成分的总抗氧化能力同时降低了1.7倍(p ˂0.001)。在患有轻度 COVID-19 的产妇组中,研究指标的变化不太明显。该研究确定了 SARS-CoV-2 在破坏 "脂质过氧化-抗氧化防御 "功能系统以及在第三孕期出现 COVID-19 的产妇中产生氧化应激方面的致病作用。研究发现,外周血中氧化应激标记物的浓度与 COVID-19 的严重程度有关。研究表明,妊娠三个月时 COVID-19 与高水平的磷脂酶 A2、促氧化-抗氧化系统失衡有关,其特点是总抗氧化能力水平降低,生物大分子的氧化修饰产物增加,表现为 DC、TBARS 和 8-异前列腺素水平的增长,导致与肺损伤严重程度相关的氧化应激。
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引用次数: 0
Diagnosis of heart failure in patients with chronic obstructive pulmonary disease 慢性阻塞性肺病患者心力衰竭的诊断
Pub Date : 2024-03-23 DOI: 10.36604/1998-5029-2024-91-123-133
T. V. Sycheva, J. Perelman
Introduction. Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently co-occur in clinical practice, presenting challenges in differential diagnosis due to shared risk factors, an adverse comorbid landscape, and nonspecific symptoms. The coexistence of COPD and CHF significantly affects the prognosis for both conditions because of their mutual exacerbation. Evaluating the heart's structural and functional status in COPD patients is essential for early identification of cardiovascular complications, thereby improving prognosis and reducing mortality.Aim. To review the latest global literature on diagnosing heart failure in COPD patients. Materials and methods. This review compiles data from literature sources, primarily from the last five years, sourced from PubMed and eLibrary, incorporating older publications as necessary.Results. The review discusses current laboratory diagnostics and medical imaging techniques for identifying heart failure, crucial for preventing severe complications. Primarily, transthoracic echocardiography stands out as the most accessible and cost-effective method, playing a pivotal role in diagnosing and monitoring heart failure today.Conclusion. Heart failure is a subject of extensive publication with a detailed description of laboratory and instrumental methods, including the latest advances in magnetic resonance and computed tomography. Transthoracic echocardiography continues to be the "gold standard" in both the diagnostic and prognostic assessment of heart failure-related changes.
导言。慢性阻塞性肺疾病(COPD)和慢性心力衰竭(CHF)在临床实践中经常并发,由于具有共同的危险因素、不利的合并症和非特异性症状,给鉴别诊断带来了挑战。慢性阻塞性肺病和慢性心力衰竭同时存在会严重影响这两种疾病的预后,因为它们会相互加重病情。评估慢性阻塞性肺病患者的心脏结构和功能状态对于早期发现心血管并发症,从而改善预后和降低死亡率至关重要。回顾有关诊断慢性阻塞性肺病患者心力衰竭的最新全球文献。材料和方法。本综述汇编了主要来自 PubMed 和电子图书馆的过去五年的文献数据,并在必要时纳入了较早的出版物。综述讨论了目前用于识别心力衰竭的实验室诊断和医学影像技术,这对预防严重并发症至关重要。其中,经胸超声心动图是最便捷、最具成本效益的方法,在诊断和监测心力衰竭方面发挥着举足轻重的作用。心力衰竭是一个需要大量出版物的主题,其中详细描述了实验室和仪器方法,包括磁共振和计算机断层扫描的最新进展。经胸超声心动图仍然是诊断和预后评估心衰相关变化的 "黄金标准"。
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引用次数: 0
The role of physical activity in improving the condition of patients with COPD (review article) 体育锻炼对改善慢性阻塞性肺病患者病情的作用(综述文章)
Pub Date : 2024-03-23 DOI: 10.36604/1998-5029-2024-91-134-148
I. Demko, M. Mamaeva, N. Gordeeva, V. S. Alekseeva
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, accounting for approximately 6% of all deaths, confirming its relevance and making it a subject of close attention of the global medical community. The integration of physical activity (PA) into the regimen of patients with COPD plays a key role in maintaining their health and improving quality of life. However, despite the inclusion of PA in pulmonary rehabilitation programs having become a routine method, questions remain today about establishing several universal formats of rehabilitation measures on the one hand and personalization on the other. This review is based on the analysis of relevant publications obtained as a result of selective literature search using the following keywords: COPD, quality of life, physical activity, pulmonary rehabilitation. Articles indicating the effects of PA as one of the main components of comprehensive pulmonary rehabilitation in patients with COPD are considered. Tools for assessing PA, its impact on the frequency of disease exacerbations, and mortality are discussed. Results confirming the importance and necessity of physical exercises as part of pulmonary rehabilitation are presented, as well as modern problems faced by specialists conducting pulmonary rehabilitation and their potential solutions.
慢性阻塞性肺病(COPD)是导致死亡的第三大原因,约占总死亡人数的 6%,这证实了它的相关性,并使其成为全球医学界密切关注的主题。将体力活动(PA)纳入慢性阻塞性肺病患者的治疗方案,对维持他们的健康和提高生活质量起着关键作用。然而,尽管将体育锻炼纳入肺康复计划已成为一种常规方法,但目前仍存在一些问题,一方面是如何建立几种通用的康复措施形式,另一方面是如何实现个性化。本综述基于对相关出版物的分析,是使用以下关键词进行选择性文献检索的结果:慢性阻塞性肺病、生活质量、体育活动、肺康复。文章指出,作为慢性阻塞性肺病患者全面肺康复的主要组成部分之一,体育锻炼对患者的影响。还讨论了评估体力活动的工具、体力活动对疾病加重频率和死亡率的影响。介绍了证实体育锻炼作为肺康复的一部分的重要性和必要性的结果,以及进行肺康复的专家所面临的现代问题及其潜在的解决方案。
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引用次数: 0
Correlation between molecules, which reflect malfunctioning of cellular respiration, degree of oxidative stress, and glycated hemoglobin in retinopaties with type 2 diabetes 反映 2 型糖尿病视网膜病变患者细胞呼吸功能失常的分子、氧化应激程度和糖化血红蛋白之间的相关性
Pub Date : 2024-03-22 DOI: 10.36604/1998-5029-2024-91-77-83
E. M. Fefelova, M. V. Maksimenya, O. A. Saklakova, T. Karavaeva, N. Kotsyurzhinskaya, P. Tereshkov
Introduction. The pathogenetic role of biochemical changes in the development of diabetic retinopathy (DR) is undoubted and determines the importance of studies that reveal metabolic disorders of both individual molecules and show the relationships between them. Because of some commonalities between tissue respiration, monosaccharide and tryptophan exchange, and activation of lipid peroxidation (LP), there is an interest in studying the relationship between metabolites of these pathways in retinopathy.Aim. The aim is to study the content of metabolites of the kynurenic pathway and intermediate product of lipid peroxidation in blood, and to reveal the correlation between them and glycated hemoglobin’s (HbA1c) level in retinopathy with type 2 diabetes.Materials and methods. The 1st group (control group) included 21 healthy people; the 2nd group included 21 people with «prediabetes», the 3rd group - 21 patients with type 2 diabetes, the 4th group - 63 people with type 2 diabetes and diabetic retinopathy (DR) of varying severity levels. The content of kynurenines in the blood plasma (kynurenine (KYN), 3-hydroxykynurenine (3-HKYN), kynurenic acid (KYNA)) of all participants, as well as the concentration of malondialdehyde (MDA) was determined by high-performance liquid chromatography using a Shimadzu LC-20 chromatograph (Japan). The level of glycated hemoglobin (HbA1c) was determined using Beckman Coulter AU 480 (USA) biochemical analyzer. The results were calculated using Jamovi program version 2.3.Results. In the group of people with «prediabetes», the values of all studied parameters in the blood plasma were increased in comparison with the control group. In the group of patients with type 2 diabetes, the levels of KYN, 3- НKYN and MDA significantly exceeded those in the group of people with «prediabetes». In the group of people with DR, all indicators remained high, the values of 3-НKYN and KYNA showed a statistical difference compared to the group of patients with diabetes. When conducting a correlation analysis, corellations were identified between the level of HbA1c on the one hand and the values of KYN (r=0.77; p ˂ 0.001), concentrations of 3-НKYN (r=0.80; p ˂ 0.001), KYNA (r= 0.72; p ˂ 0.001) and MDA (r=0.84; p ˂ 0.001) – on the other. There was a correlation between HbA1c level and fundus scale (r=0.82; p ˂ 0.001) and between concentrations (of 3-HKYN) and MDA (r=0.50; p=0.002).Conclusion. An increased level of glycosylated hemoglobin and lipid peroxidation products in the blood during retinopathy against the background of type 2 diabetes, an increase in the concentrations of KYN, 3-HKYN, KYNA, and the presence of correlations between these indicators serve as the basis for proving the relationship of uncontrolled hyperglycemia with changes in cellular respiration and the development of oxidative stress. Hypoxic effects and the accumulation of intermediate metabolic products of the kynurenine pathway contribute to progressive neurovascular d
导言。生化变化在糖尿病视网膜病变(DR)发展过程中的致病作用毋庸置疑,这也决定了揭示单个分子代谢紊乱和显示它们之间关系的研究的重要性。由于组织呼吸、单糖和色氨酸交换以及脂质过氧化活化(LP)之间存在一些共性,因此研究视网膜病变中这些途径的代谢物之间的关系很有意义。目的是研究 2 型糖尿病视网膜病变患者血液中犬尿苷途径代谢物和脂质过氧化中间产物的含量,并揭示它们与糖化血红蛋白(HbA1c)水平之间的相关性。第一组(对照组)包括 21 名健康人;第二组包括 21 名 "糖尿病前期 "患者;第三组--21 名 2 型糖尿病患者;第四组--63 名 2 型糖尿病和不同严重程度的糖尿病视网膜病变(DR)患者。所有参与者血浆中的犬尿氨酸含量(犬尿氨酸(KYN)、3-羟基犬尿氨酸(3-HKYN)、犬尿酸(KYNA))以及丙二醛(MDA)浓度均通过使用岛津 LC-20 色谱仪(日本)的高效液相色谱法进行测定。糖化血红蛋白(HbA1c)水平使用贝克曼库尔特 AU 480(美国)生化分析仪测定。结果用 Jamovi 程序 2.3 版计算。与对照组相比,"糖尿病前期 "患者血浆中的所有研究参数值都有所增加。在 2 型糖尿病患者组中,KYN、3-НKYN 和 MDA 的水平明显高于 "糖尿病前期 "患者组。在 DR 患者组中,所有指标都保持在较高水平,3-НKYN 和 KYNA 的值与糖尿病患者组相比有统计学差异。在进行相关分析时,发现 HbA1c 水平与 KYN 值(r=0.77;p ˂0.001)、3-НKYN 浓度(r=0.80;p ˂0.001)、KYNA(r=0.72;p ˂0.001)和 MDA(r=0.84;p ˂0.001)之间存在核心关系。HbA1c 水平与眼底标度之间存在相关性(r=0.82;p ˂ 0.001),3-HKYN 浓度与 MDA 之间也存在相关性(r=0.50;p=0.002)。在 2 型糖尿病的背景下,视网膜病变期间血液中糖化血红蛋白和脂质过氧化产物的水平升高,KYN、3-HKYN 和 KYNA 的浓度升高,以及这些指标之间存在相关性,这些都是证明失控的高血糖与细胞呼吸变化和氧化应激发展之间关系的依据。缺氧效应和犬尿氨酸途径中间代谢产物的积累会导致视网膜神经血管逐渐受损,激活脂质过氧化过程和炎症。
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引用次数: 0
Atmospheric ground layer pollution by suspended solid particles in areas with different technogenic loads 不同技术负荷地区悬浮固体颗粒对地面大气层的污染
Pub Date : 2024-03-22 DOI: 10.36604/1998-5029-2024-91-68-76
E. V. Kondratyeva, T. Vitkina, L. V. Veremchuk
Introduction. According to the World Health Organization ambient air pollution causes enormous harm to public health around the world. Atmospheric solid suspended particles are a heterogeneous mixture of substances with various dimensional, qualitative and quantitative parameters. They are a key indicator of air pollution, contributing to the bronchopulmonary pathology formation. At the moment, there is no general recommended ranking of the solid suspended particles amount in the atmospheric air.Aim. Determination of the SSP fractional content in the air ground layer in high and relatively low technogenic load areas of Vladivostok.Materials and methods. Atmospheric air samples were taken «in the breathing zone» using an electric aspirator. In the granulometric analysis of SSP, the particle size distribution, expressed as a percentage, and the mass concentration of fractions (μg/m3 ) were determined. The ranges of dimensions have been identified, taking into account the solid suspended particles possible origin and the expected pathophysiological features of their effect on the organism.Results. An area with a high technogenic load is characterized by the prevalence of particles with a diameter of up to 10 microns, which have the most pathogenic effect on the organism. In an area with a relatively low technogenic load, particles of larger fractions (10-25, 1000-2000 microns) predominate.Conclusion. Studying the solid suspended particles parameters in specific areas and establishing their influence cellular mechanisms can help in the development of new strategies for the prevention of environmentally-related pathologies.
导言。世界卫生组织指出,环境空气污染对全球公众健康造成了巨大危害。大气中的固体悬浮颗粒是一种具有不同尺寸、质量和数量参数的异质混合物。它们是空气污染的一个关键指标,有助于支气管肺部病变的形成。目前,还没有关于大气中固体悬浮颗粒物含量的通用建议等级。测定符拉迪沃斯托克高技术负荷和相对低技术负荷地区空气地面层中的固体悬浮颗粒物分数含量。使用电动吸气器在 "呼吸区 "采集大气样本。在对 SSP 进行粒度分析时,确定了以百分比表示的粒度分布和馏分的质量浓度(μg/m3)。考虑到固体悬浮颗粒的可能来源及其对生物体影响的预期病理生理特征,确定了尺寸范围。高技术负荷地区的特点是颗粒直径达 10 微米,对生物体的致病作用最大。在技术负荷相对较低的地区,较大颗粒(10-25、1000-2000 微米)占主导地位。研究特定地区的固体悬浮颗粒参数并确定其影响细胞的机制,有助于制定预防与环境有关的病症的新策略。
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引用次数: 0
Interleukin 8 and bronchial phagocytes in patients with non-allergic asthma and diverse respiratory responses to cold stimulus 非过敏性哮喘患者的白细胞介素 8 和支气管吞噬细胞以及对冷刺激的不同呼吸反应
Pub Date : 2024-03-22 DOI: 10.36604/1998-5029-2024-91-50-58
A. Pirogov, A. Prikhodko, J. Perelman
Introduction. The role of phagocytes, regulated by interleukin 8 (IL-8), in the formation of the bronchial response to environmental stimuli in patients with asthma is not well understood.Aim. To study the functional activity of IL-8 and the pool of phagocytic cells in the inflammatory pattern of the bronchi in patients with non-allergic asthma during inhalation exposure to cold air.Materials and methods. In 129 patients with mild to moderate asthma, the content of IL-8 and the cellular composition of sputum before and after the bronchoprovocation test with isocapnic hyperventilation with cold air (-20°C) (IHCA) were analyzed.Results. Based on the results of the IHCA by the assessment of changes in FEV1 (Δ,%), 54 patients (1st group) were verified with cold airway hyperresponsiveness (CAHR), the comparison group consisted of asthma patients (2nd group, n=75) who did not respond to the trigger (ΔFEV1 = -18.9±1.2 and -3.3±0.4%; p<0.0001, respectively). The content of neutrophils in sputum before provocation was 41.1±2.2% and 34.5±2.2% (p><0.05), macrophages – 36.2±2.7% and 43.1±2.5% (p> ˂ 0.0001, respectively). The content of neutrophils in sputum before provocation was 41.1±2.2% and 34.5±2.2% (p ˂ 0.05), macrophages – 36.2±2.7% and 43.1±2.5% (p>0.05), respectively. In response to the IHCA in the 1st group, the number of neutrophils increased to 48.2±2.0% (p ˂ 0.05), macrophages decreased to 28.7±2.1% (p ˂ 0.01), and the level of IL-8 increased from 12838±2328 to 17412±2980 pg/mL (p ˂ 0.05). In the 2nd group, the concentration of IL-8 before the IHCA was 14639±2691 pg/mL, after the test 10545±1746 pg/mL (p>0.05); the number of neutrophils after the test 40.0±2.3% (p>0.05); macrophages – 35.8±2.0% (p ˂ 0.01).Conclusion. In asthma patients with CAHR, the inflammatory pattern of the bronchi in response to the cold trigger shows enhanced IL-8 activity and more pronounced changes in the content of phagocytes, mobilized with the involvement of this cytokine.
导言。白细胞介素 8(IL-8)调节的吞噬细胞在哮喘患者支气管对环境刺激形成反应中的作用尚不十分清楚。研究非过敏性哮喘患者在吸入冷空气时支气管炎症模式中 IL-8 的功能活性和吞噬细胞池。对129名轻度至中度哮喘患者进行冷空气(-20°C)等压过度通气支气管舒张试验(IHCA)前后的IL-8含量和痰液的细胞成分进行分析。根据 IHCA 的结果,通过评估 FEV1 的变化(Δ,%),54 名患者(第一组)被证实患有冷气道高反应性(CAHR),对比组包括对触发无反应的哮喘患者(第二组,n=75)(ΔFEV1 = -18.9±1.2 和 -3.3±0.4%;p ˂0.0001)。激发前痰中中性粒细胞的含量分别为 41.1±2.2% 和 34.5±2.2% (p˂0.05),巨噬细胞的含量分别为 36.2±2.7% 和 43.1±2.5% (p>0.05)。第一组对 IHCA 的反应是,中性粒细胞数量增加到 48.2±2.0%(p ˂0.05),巨噬细胞减少到 28.7±2.1%(p ˂0.01),IL-8 水平从 12838±2328 pg/mL 增加到 17412±2980 pg/mL(p ˂0.05)。在第二组中,IL-8在IHCA前的浓度为14639±2691 pg/mL,试验后为10545±1746 pg/mL(p>0.05);试验后中性粒细胞的数量为40.0±2.3%(p>0.05);巨噬细胞-35.8±2.0%(p ˂0.01)。患有 CAHR 的哮喘患者支气管对寒冷诱因的炎症反应模式显示 IL-8 活性增强,吞噬细胞含量变化更明显,该细胞因子参与了吞噬细胞的动员。
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引用次数: 0
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Bulletin Physiology and Pathology of Respiration
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