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PROGNOSTIC CRITERIA FOR CORONARY HEART DISEASE
Yakhyoeva Firuza Obidovna
Bukhara State Medical Institute
https://doi.org/10.5281/zenodo.13336234
Introduction.
Of particular interest are the issues of gender differences in patients with
coronary heart disease, an atypical form of angina pectoris. Coronary heart
disease is not a linearly progressive, stable process. CHD is characterized by a
change of phases of stable course and exacerbation of the disease. In the
population, only about 40-50% of all patients are aware of the presence of the
disease and receive appropriate treatment, whereas in 50-60% the disease
remains unrecognized [1].
Patients diagnosed with stable angina pectoris die from coronary heart
disease 2 times more often than those without this disease [2].
The purpose of the study:
To study the cytokine status in CHD depending
on gender in order to develop criteria for the severity of its course.
Materials and methods of research:
The study included 120 patients with coronary heart disease aged 25 to 85
years (the average age of men was 62.6 ± 1.47 years, and women 63.4 ±1.14
years). The comparison group consisted of patients with progressive angina
pectoris (PS), a total of 65 patients, including 31 women and 34 men (average
age 64.2 ± 1.37 years).
The verification of coronary heart disease was carried out according to the
requirements of the World Health Organization (WHO), classified according to
the international classification of diseases (ICD-10).
The results and their discussion.
The ratio of men-66 (55.0%) and women-54 (45.0%) was 1.2:1.0. A
comparative analysis of the frequency of coronary heart disease, taking into
account gender, showed an increase in cases of coronary heart disease in men
aged 50 years and older - 57 (86.4%), in women aged 50 to 74 years - 44
(81.5%).
The study of cytokines in coronary heart disease showed an increase in the
level of IL-1 to 77.6±1.29pg/ml in relation to the indicators of patients of the
comparative and 2nd groups:60.6±1.14pg/ml and 65.0±2.12 pg/ml,
respectively, P<0.05.
At the same time, the threshold level indicating the development of
inflammation in CHD in women is the concentration of IL-1 >67.0 pg/ml.
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CHD in women is also accompanied by a decrease in the level of IL-10 by 1.5
times, against the values of the 2nd group-43.8±2.19 pg/ml. Consequently, in
women, coronary heart disease is accompanied by a decrease in IL-10, while the
threshold level is IL-10<6.25 pg/ml.
It should be noted that IL-10 of the comparative group was reduced to -
34.5±0.28 pg/ml, against the indicators of the 2nd group (p<0.05). This means
that during the transition of coronary heart disease to PS, there is a decrease in
IL-10, which indicates the depletion of the protective mechanisms of immunity.
The study of the state of vascular endothelin factor in coronary heart
disease revealed an increase in the concentration of VEGF in men to -104.5±2.15
pg/ml relative to the indicators of group 1- 92.7±3.51 pg/ml (p<0.05).
Consequently, in men with coronary heart disease, in response to damage to the
vascular wall as a result of impaired microcirculation in the myocardium and
spasm of the coronary vessels, there is an increase in vascular endothelin factor
in the blood by 1.12 times compared to the values of group 1 (in women).
Thus, in women, coronary heart disease without ST segment elevation
occurs against the background of anemia and lymphocytopenia.
A comparative analysis of the studied blood parameters in men, depending
on the state of the segment, with coronary heart disease with ST segment
elevation showed an increase in the level of Hb to 120.7±1.33 g/l against these
men without its elevation -113.9±2.35 g/l. The remaining indicators did not
depend on the ST shift and were at the same level in men.
At the same time, for both women and men, the threshold level indicating
the development of inflammation in coronary heart disease is the concentration
of IL-1 >67.0 pg/ml. Indicators of the severity of coronary heart disease in
women are anemia, leukocytosis and lymphocytopenia.
Conclusion:
1. Coronary heart disease without ST segment elevation in women occurs
against the background of anemia and lymphocytopenia. Men are characterized
by the absence of a connection between laboratory blood parameters and a shift
in the ST segment.
2. In men with coronary heart disease, there is an increase in vascular
endothelin factor in the blood by 1.12 times, IL-1 by 1.7 times.
3. The threshold level indicating the development of inflammation in coronary
heart disease for both women and men is the concentration of IL-1 >67.0 pg/ml.
References:
1.
Альмухамбетова Р.К., Ш.Б. Жангелова, М.Б. Жангелова, Г.Ж. Уменова
Кардиопротективная стратегия в терапии ИБС // Вестник КазНМУ. 2015.
ACADEMIC RESEARCH IN MODERN SCIENCE
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№3. URL: https://cyberleninka.ru/article/n/kardioprotektivnaya-strategiya-v-
terapii-ibs (дата обращения: 02.03.2023).
2.
Ganieva Sh.Sh, & Akhrorov J.X. (2022). Этиопатогенетические
Особенности
Ремоделирования
Сердца
При
Кардиоваскулярной
Патологии. Periodica Journal of Modern Philosophy, Social Sciences and
Humanities,
13,
101–105.
Retrieved
from
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