функциональный резерв мозга у больных артериальной

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616.12-009
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. .,
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.,
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.,
. .,
«
.
.
.,
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, 42), e-mail: vi ctor_mashin@ mail. ru
).
.
,
103
– 56,5±12,8
.
7
,
66 (64,1 %)
.,
.
,
,
6,8 %, II
–
56
– 9,0±6,46
30 (29,1 %)
(432000,
47
.
,
I
III
.
D.
Celermajer (1992).
,
,
-
,
.
,
-
.
:
,
,
.
BRAIN FUNCTIONAL RESERVE OF PATIENTS WITH ARTERIAL HYPERTENSION
Mashin V. V., Belova L. A., Ruzov V. I., Dremkov D. Y., Gavrilov V. M.,
Vinokurov L. N., Mashin E. V., Abramova V. V., Kolotic-Kameneva O. Y.
Ulyanovsk State University, Ulyanovsk, Russia (432017, Ulyanovsk, L.Tolstoy str., 42), e - ma i l :
vi ct or_mashin@mail.ru
We conducted analysis of the functional reserve of the brain with arterial hypertension (AH). The work is based
on the results of a survey of 103 patients AH, of which 56 men and 47 women, average age-56.5 ± 12.8 years. The
average duration of the AH in patients – 9.0 ± 6.46 years. AH I diagnosed in 7 patients, which was 6.8 %, II-30
(29.1 %), AH III in 66 (64.1 %) patients. Endothelial dysfunction was assessed on the vasoactive function of the
endothelium using ultrasound tests reactive hyperemia by d. Celermajer (1992). Reduction of cerebrovascular
reactivity and endothelial dysfunction in the form of endothelium-dependent vasodilation brachial artery
correlated with the age of the patient, the AH, stage hypertensive encephalopathy, chronic heart failure and left
ventricular hypertrophy. During the study the expediency of accounting as predictors of diffuse brain injury of
ischemic cerebrovascular reactivity and endothelial dysfunction.
Key words: arterial hypertension, functional reserve of the brain, endothelial dysfunction.
.
,
(
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-
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–
(
) [6, 2].
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,
[3,4].
-
,
[1,5,7].
2
85 %
) [6].
-
,
.
.
.
.
103
-
,
.
,
– 56,5±12,8
9,0±6,46
.
47
.
I
–
7
30 (29,1 %)
56
,
III
6,8 %, II
66 (64,1 %)
–
.
30
,
.
.
-
,
.
(SS -660
).
(
(
(
),
)
(
,
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(
Toshiba,
),
-
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-
),
(
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SS -660 .
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,
3
,
,
(IR)
(
(PI),
),
(
).
-
,
(
)
.
,
:
,
,
, IR, PI.
-
0,25
,
15–20
%.
,
5
,
-
.
Statistica 5.5.
-
.
.
,
,
-
.
(
-
)
,
89 %
,
–
.
-
.
:
33 (32 %)
(3,9 %).
,
11 (11 %)
II
–
I
,
,
II
55 (43,4 %)
,
.
. – 42 (40,8 %),
I
III
.
II
–
4
,
.
28 (27,2 %)
. – 22 (21,4 %)
I
I
.
(n=23)
-
(n=53)
.
(52,8 %),
–
(n=27)
.
.
14,8 %
18,9 %,
–
–
11,3 %
28,3 %
,
(
. 1).
-
4
(
. 1).
-
2
3
2
2
1
1
0
0,0%
20,0%
40,0%
60,0%
80,0%
100,0%
0,0%
20,0%
40,0%
60,0%
80,0%
,%
100,0%
,%
. 1.
.
,
II
,
.
,
,
(63,6 %).
,
,
(92,4 %),
,
(81,8 %).
,
,
,
(P<0,05),
.
.
,
"
(59,8 %
34,8 %
"
"
"
).
I
(50,0 %
68,9 %
; P<0,05),
II
-
"
III
"
(66,7 %).
,
:
– 0,8±0,29
,
II
– 1,0±0,26
III
– 1,1±0,33
(
(
)
)
I
.
-
5
(
)
(
.
. 1),
-
,
-
,
-
.
1
(
)
36,9±14,1
40,2±14,5
36,5±11,6
34,2±20,6
39,4±9,8
38,9±14,8
38,4±12,8
I . (N=23)
II . (N=53)
III . (N=27)
(N=11)
I . (N=33)
II
. (N=55)
II
. (N=4)
)
(
)
28,6±7,8
26,8±8,5
20,9±12,0
23,5±12,8
28,6±8,1
24,5±9,9
22,4±10,7
653±308,5
791±408,6
933,1±368,9
612,9±418,7
805,8±295,0
816,6±422,8
889,8±564,3
(P<0,05)
)
307,3±130,6
300,0±146,6
292,7±218,9
289,4±255,2
319,1±128,1
290,5±163,9
280,1±211,1
.
,
(
. 2).
(P<0,05).
80
100
75,1
91,3
90
70
62,9
60,9
80
76,3
60
70
50
60
40
56,3
50
40
30
30
27,2
20
20
10
10
0
0
I
II
III
0
I
IIA
II
. 2.
(
).
,
,
-
.
.
15,5±2,96 %,
II
.–
,
8,2±5,02 %,
I
III
.–
2,3±4,4 %.
,
(
. 2).
6
(7,3±6,2 %)
(15,0±2,71 %).
(P<0,05).
,
13,0±3,92 %,
I
II
. – 5,4±4,66 %,
II
. –
2,5±2,92 %.
3-
5-
(P>0,05).
.
( <0,001)
-
.
2
.
315,54±2,96
7,83±4,96
7,26±4,74
0,89±3,60
3,40±4,92
514,38±3,87
9,34±4,96
8,60±5,27
2,12±5,03
4,20±5,31
-2,00±2,83
0,0±0,0
,
,
,
.
,
:
,
,
,
.
,
(
(25,0±7,46 %)
-
)
.
(6,7±10,12 %),
,
II
. 3)
.
,
III
.
,
-
,
.
3
7
I .
(n=23)
13,7±12,12
<0,001
(%)*,
II .
(n=53)
10,6±9,43
<0,001
III .
(n=27)
-0,6±9,11
<0,001
. *
(n=30)
35,4±5,82
,
.
,
( <0,001).
( >0,05)
-
.
(P<0,05).
,
.
( <0,001)
-
,
"
"
.
.
-
( <0,05),
,
( <0,01).
-
( <0,05).
.
III
.
(P<0,05).
,
-
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,
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-
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II
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8
1.
.
.
/ .
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//
2.
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. – 2003. –
3.
.
/
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. .
, .
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,
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//
1. – . 46 – 48.
//
,
4.
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,
12. – . 32 – 36.
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/ . .
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.–
-
., 2003. – . 4 – 39.
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//
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1. – . 38 – 43.
5.
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6.
. .
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/
. .
//
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13. – . 14 – 18.
,
, . .
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.–
., 2006. – 200 .
7. Becker B. F. Endothelial function and hemostasis / B. Heindl, C. Kupatt, S. Zahler // J. Kardiol.
– 2000. –
89 (3). – . 160 – 167.
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