Introduction. Better understanding of the pathogenesis of hemophilic arthropathy is crucial for prevention of irreversible injury to joints in patients with hemophilia. Research objective - to define a role of altered regulation of microcirculation in formation of joint injury in patients with hemophilia. Methods. The changes in knee and ankle joints in 82 patients with hemophilia were investigated by means of ultrasound and X-ray. Microcirculation was evaluated using computer infrared thermography and laser doppler flowmetry in joints of 44 patients and 46 healthy individuals. Results. Increased temperature and perfusion (M) are major risk factors of hemarthrosis development (RR=1.86 and RR=1.26) and are characteristic of joints with hemorrhages developing more often than 1 time per month. Increase in these indexes in joints without hemarthrosis in the anamnesis is a sign of a latent inflammation. Both decrease in the index of shunting (IS) and increase in a vibration amplitude of perfusion in the endothelial range (Amax E) are characteristic of joints with a recurrence of hemarthrosis more often than 3 times a month. Decrease in indexes of M and Amax E with concomitant increase in PSh demonstrate low risk of hemarthrosis. Conclusions. Changes of microcirculation in joints represent an important factor in the pathogenesis of hemophilic arthropathy development in the patients with variable risk of a recurrence of a hemarthrosis. Joint inflammation leads to endothelial dysfunction with poor vasospasm, to increase in Amax E and M that is a new diagnostic sign of a latent inflammation in joints. Decrease of PSh promotes recurrence of hemarthrosis because of strengthening of an imbuing of tissues of joint blood. Preservation of endothelium-mediated vasoconstriction, decrease in the neurogenic tone, increase in shunting of blood are characteristic features of hemophilic arthropathy in patients with infrequent recurrence of hemarthrosis.
The activity of lactate, malate, glutamate and glucose-6-phosphate dehydrogenases was studied in the blood serum of 107 patients with acute pneumonia with various clinical variants of the course of the disease, as well as in 22 rabbits with experimental staphylococcal pneumonia in lung tissue homogenate and blood serum. It was found that the change in the activity of the studied enzymes in the blood serum in the dynamics of the disease reflects metabolic disorders in the lungs, the level of damage to cell structures.
Aim. To study the particularities of metabolism associated with AB0 system blood groups by examination of carbohydrate exchange serum parameters. Methods. 446 healthy subjects with different blood groups were examined: 0 (I) blood group - 29.6%, A (II) - 31.8%, B (III) - 24.3%, AB (IV) - 14.3%. The blood group was defined by direct agglutination test in all subjects, piruvate, lactate, glucose, cortisol and insulin serum levels, lactatdehydrogenase and α-аmylase activity was defined using an automatic biochemical analyzer. Results. Group specific features of carbohydrate metabolism in subjects with different blood groups were revealed. In subjects with 0 (I) blood group the lowest glucose and insulin serum levels, the highest amylase activity and piruvate and lactate blood levels were characteristic; in subjects with A (II) blood group - highest level of insulin and cortisol, low lactate levels; in subjects with B (III) blood group - maximal lactatdehydrogenase and minimal amylase activity, high piruvate and lactate blood levels; in subjects with AB (IV) blood group - highest level of glucose, low lactatdehydrogenase and amylase activity, lowest lactate and piruvate blood levels were revealed. Conclusion. The particularities of molecular processes might be associated with blood group and predispose to different health conditions. The features of the metabolic profile of patients with different blood groups are the rationale for individualization of personal standards for each person that might reasonably be considered in clinical practice.
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