Ассоциация полиморфизма 4а / 4b и 4b / 4b гена эндотелиальной синтазы оксида азота с маркерами дисфункции эндотелия у больных ХСН Ключевые слова: ХСН, эндотелин-1, натрийуретический пептид типа С
Aim. To develop a mathematical equation (algorithm) to predict the development of chronic heart failure (CHF) for three years, depending on the clinical phenotype.Material and methods. Three hundred forty five patients with CHF with a different left ventricular ejection fraction (preserved, mean, low) were examined. The control group included somatically healthy individuals (n=60). In all patients, 48 parameters that most widely characterize the pathogenesis of CHF (gender-anamnestic, clinical, instrumental, biochemical) were analyzed. To isolate phenotypes, dispersive and cluster analysis was used: the hierarchical classification method and the k-means method. In the development of algorithms we used binary logistic regression method. We used ROC curve to assess the quality of the obtained algorithms.Results. We identified four phenotypes in patients with CHF: fibro-rigid, fibro-inflammatory, inflammatory-destructive, dilated-maladaptive. For the first three phenotypes, a mathematical logistic regression method was used to develop mathematical models for predicting the progression of CHF for three years, with the release of predictors for each phenotype. Belonging to the dilatedmaladaptive phenotype according to the results of the analysis is already an indicator of an unfavorable prognosis in patients with CHF.Conclusion. The developed algorithms based on the selected phenotypes have high diagnostic sensitivity and specificity and can be recommended for use in clinical practice.
Morbidity is one of the indicators of population health. In recent years, there has been an increase in the incidence of children, an increase in chronic diseases. The article analyzes the dynamics of the incidence of cadets in the Astrakhan region. As a result of the study, a persistent trend was revealed to increase the number of children included in the first health group. The number of children included in the third health group has decreased. In the structure of the incidence of ophthalmic pathology, the dominant place is occupied by myopia and spasm of accommodation. There is also a low prevalence of gastrointestinal tract morbidity among cadets. The results obtained point to the positive impact of sports and drill load on the development of the musculoskeletal system of children. Sports combat training contributes to the adequate development of the muscular system, which, of course, is the prevention of posture disorders and harmonious development.
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