aspects of correction of neurohumoral system activity... 47 vasodilation. Vasoconstrictive responses occur within the sympathoadrenal system and the renin-angiotensin-aldosterone system (RAAS), and are induced by vasopressin, serotonin, endothelin, and thromboxane A 2. Vasodilative responses involve the kinin system, natriuretic peptides (NP), prostaglandins I 2 and E 2 , endothelium-dependent relaxing factor, adrenomedullin, and other mediators. Correction of the neurohumoral activity in the early and late stages of MI is one of the main aspects of MI treatment and prevention of its complications. β-adrenergic blocking agents, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and aldosterone antagonists are currently used for this purpose. There are also some new classes of drugs including renin inhibitors, NP, vasopeptidase blockers, endothelin, and vasopressin receptor antagonists, at various stages of clinical investigation. β-adrenergic blocking drugs β-adrenergic blocking drugs decrease myocardial oxygen need, improve coronary blood flow, promote ischemia improvement, and infarction size reduction. According to a meta-analysis of 22 randomized trials with the participation of more than 25,000 patients, 2 a long-term administration of β-adrenergic blocking drugs resulted in the reduction of all-cause
Цель исследования-изучить эффективность мексидола (этилметилгидроксипиридина сукцината) при почечном повреждении у больных острым инфарктом миокарда с подъемом сегмента ST (ОИМпST). Материал и методы. Обследовано 55 больных с ОИМпST. Определяли острое почечное повреждение (ОПП) по критериям базального (расчетного) креатинина, сывороточному креатинину, скорости клубочковой фильтрации, цистатину С и NGAL. Лицам с ОПП к стандартной схеме лечения ОИМпST добавляли антиоксидант (цитопротектор) мексидол с 1-го по 10-й день в дозе 750 мг/сут парентерально (внутривенно). Оценивали показатели ОПП в результате лечения мексидолом. Результаты. Среди 55 больных с ОИМпST зарегистрировано 36 пациентов с признаками ОПП. Проводимая терапия с добавлением мексидола в схему лечения показала положительный результат в виде достоверного снижения маркеров почечного повреждения (креатинина, цистатина С и NGAL мочи) уже через 48 ч. Заключение. Мексидол может использоваться в добавлении к стандартной терапии больных с ОИМпST с признаками ОПП для уменьшения проявления этого грозного осложнения. Ключевые слова: цитопротекторы, инфаркт миокарда, острое повреждение почек (или острое почечное повреждение).
Accreditation of specialists in the medical education system began to be applied on January 1, 2016. Two types of accreditation (primary and primary specialized) have already been introduced into the educational practice of medical educational institutions and are successfully functioning. The third type of accreditation — periodic accreditation will start functioning from January 1, 2021.
Methodical guidelines are devoted to the functional status control and medical support of young female athletes in team sports and are intended for sports doctors and the coaching staff of teams.
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