Гиперурикемия в патогенезе, клинике метаболического синдрома и развитие сердечно-сосудистых осложнений

Аннотация

Objects of research: 296 patients with ischemic heart disease, including 105 patients with acute myocardial infarction and 191 patients with stable and unstable stenocardia. Purpose of work: to prove scientifically the pathogenic importance of hyperuricemia in formation of metabolic syndrome and cardiovascular complications, to develop criteria of diagnosis, prevention and prognosis of the disease, adequate tactics oftheir treatment. Method of research: clinical, clinical-instrumental, biochemical, statistical. The results obtained and their novelty: At patients with hyperuricemia on the basis of complex clinical, clinical-instrumental and biochemical investigations the importance of hyperuricemia as important risk factor of development of functional-metabolic disturbances in heart and vessels which arc closely connected with endothelial dysfunction, development of ischemic heart diseases and acute coronary syndrome for the first time is revealed, it is proved that hyperuricemia leads to decrease of vascular NO-synthasc reactivity, and, as consequence, causes an ischemia, activation of the processes stimulating metabolic disorder. High frequency of anginous attacks in patients with progressing unstable stenocardia and acute myocardial infarction is associated with increase in concentration of uric acid in blood, decrease in the level of nitric oxide in erythrocyte membranes, NO-synthasc activity, increase of reaction speed ofNADPN- dependent nitrate reductase, expression of pcroxinitritc, inhibition of activity of enzyme supcroxiddismu-tazc that proves their importance in pathogenesis of cardio-vascular diseases in patients with asymptomatic hyperuricemia. Practical value: Basic researches have allowed to open from new positions a role of asymptomatic hyperuricemia in development of mechanisms of endothelial dysfunction, functional-metabolic disorders in blood and to develop new principles of diagnosis, prognosis, strategy and tactics of treatment of patients with MC and cardio-vascular diseases. Degree of embed and economic effectivity: The received results arc introduced in medical practice of Samarkand branch of Republican scientific centre of emergency medical care, Republican special scientific-practical medical centre of therapy and medical rehabilitation, in educational process of Tashkent Medical Academy and Samarkand State Medical Institute. Field of application: internal diseases, cardiology, endocrinology.