No. 1 (2020) Journal of cardiorespiratory research

Статьи

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  ESTIMATION OF EFFECTIVENESS OF IMMUNO-CORRECTIVE THERAPY IN PATIENTS WITH CHRONIC OBSTRUCTIVE BRONCHITIS Chronic obstructive bronchitis (COB) is part of chronic obstructive pulmonary disease (COB) and is the most common of all forms of COB. COB is considered an unfavorable variant of COB due to increasing impairment of pulmonary ventilation, gas exchange and the development of severe complications. The study examined the clinical and immunological effectiveness of the immunomodulator of bronchomunal in patients with chronic obstructive bronchitis. The study involved 20 patients suffering from chronic obstructive bronchitis aged 15 to 35 years. The results of the study showed that the clinical and immunological effectiveness of bronchomunal allows the use of these drugs in the treatment of chronic obstructive bronchitis. Clinical indicators for the appointment of bronchomunal in patients with COB are frequent exacerbations with relapses of respiratory tract infections.

  Ne’matilla Aralov, Mukhayo Kholzhigitova

  67-71

  86   67

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  EVALUATION OF ARTERIAL BLOOD PRESSURE DAILY MONITORING INDICATORS IN PATIENTS WITH CHRONIC GLOMERULONEFTRITIS Arterial hypertension (AG) is one of the most common forms of pathology and one of the most serious problems of modern medicine. Hypertension is a major risk factor for the cardiovascular system, and its provalehce is leading to increased disablitily and reduced life expactancy for people around the world. Kidney-related hypertension accounts for approximately 4-5% of all hypertensive patients and the largest group of secondary hypertensives. A special examination was performed on 50 patients with chronic glomerulonephritis (SGN) and the medical history of 70 patients was studied. In addition to general clinical examinations, patients underwent daily monitoring and ECG of AQB . AG in SGN is characterized by a violation of chronobiological parameters of blood pressure-an increase in blood pressure during the day, night and day, with insufficient blood pressure at night and high blood pressure. This circulatory disturbance is associated with kidney damage and decreased nitrogen excretion. AG in SGN is characterized by a violation of chronobiological parameters of blood pressure-an increase in blood pressure during the day, night and day, with insufficient blood pressure at night and high blood pressure. This circulatory disturbance is associated with kidney damage and decreased nitrogen excretion

  Saodat Yarmuhamedova, Murodjon Normatov

  103-108

  62   15

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  QUALITY OF PRIMARY MEDICAL CARE IN PATIENTS WITH CHRONIC HEART FAILURE The article presents the analysis of the quality of medication therapy for patients with chronic heart failure of various degrees of severity, observed at general practitioners, and the performance of the prescribed treatment by patients. The evaluation of quality and efficiency of medication treatment of CNS patients by general practitioners and factors influencing the observance of patients' medical recommendations has been carried out. The retrospective research was conducted in four family policlinics of Samarkand. The study included 78 men and 63 women diagnosed with CNS of I-IV functional class (FC) at the age of 47 to 83 years (average 66.4±7.8 years). There were 19.3% of patients with I FC, 35.7% with II FC, 37.9% with III FC and 7.1% with IV FC. As shown by the results of the study, medication treatment prescribed by general practitioners, met modern standards in 38.6% of patients: 54.5% of patients with CNS I-II FC and 19% of patients with III-IV FC. The most frequent drawbacks of treatment were insufficient prescription of IAPF, BAB, diuretics. Implementation of medication recommendations by CNS patients was not complete enough.

  Shoira Khusinova

  99-102

  80   33

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  STUDY OF SERUM CYTOKINE LEVELS IN VARIOUS FORMS OF SEVERE BRONCHIAL ASTHMA Bronchial asthma (BA) is considered as a heterogeneous pathogenetic disease, which can be based on both immunological and non- immunological mechanisms United by a common pathogenetic link. The study of cytokine levels provides information about the functional activity of various types of immunocompetent cells, the severity of the inflammatory process, its transition to the systemic level, and the ratio of activation processes of T-helper types 1 and 2. For this purpose, 45 patients with AB were examined. The first group included 17 patients with allergic BA (ABA), the second group included 11 patients with non – allergic BA (NBA), and the third group consisted of 17 patients with mixed BA (MBA). The level of IFN-γ, IL-4 in blood serum was determined using test systems for quantitative determination by solid-phase IFA.The obtained results show some dependence of IL-4 and IFN-g levels in patients with AB with a pathogenetic variant of the disease, the distinctness of which is more pronounced in patients with ABA. In patients with ABA and MAB, there is a pronounced inhibition of IFN-γ production, while in patients with AB with a predominantly allergic mechanism of the disease, a significant increase in the level of IL-4 is registered.

  Khusan Turdibekov, Irina Agababyan, Baxtiyor Nizomov

  95-98

  68   20

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  SIGNIFICANCE OF FUNCTIONAL DISORDERS OF THE KIDNEYS IN PATIENTS WITH MYOCARDIAL INFARCTION ON THE BACKGROUND OF TYPE 2 DIABETES MELLITUS The aim of the study was to study the role of kidney dysfunction in the weighting of acute myocardial infarction (MI) clinic against the background of type 2 diabetes mellitus (DM 2). 104 patients with acute myocardial infarction were examined: 40.4% of women and 59.6% of men. 65.4% of patients had type 2 diabetes. It was found that in type 2 diabetes, MI often develops in women of relatively older age (over 60 years), with a duration of diabetes of more than 5 years, with a subcompensated or decompensated course of the disease. In type 2 diabetes, impaired renal function is a risk factor for developing and exacerbating the severity of MI. Signs of nephropathy proteinuria, cylinduria and a decrease in glomerular filtration below 80 ml / min are the background for the development of myocardial infarction. Lowering the GFR in MI patients with type 2 diabetes below 60 ml / min may contribute to fatal outcomes.

  Aziz Toirov, Eleonora Tashkenbaeva, Erkin Toirov

  91-94

  66   14

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  STUDY OF POLYMORPHISM OF IL-1 T / C 511 GENE IN PROGRESSION OF UNSTABLE STENCARDIA IN PATIENTS WITH COMORBIDE PATHOLOGIES The study was conducted at the Samarkand branch of the Republican Center for Emergency Medicine. The study included 205 patients with a diagnosis of unstable angina. The average age of patients was 62.4 years. In our study, the female gender prevailed and amounted to 58.1%. In our study, we studied IL-1 β gene polymorphism — replacing cytosine (C) with thymine (T) at position –511. DNA was isolated from peripheral blood lymphocytes by perchlorate extraction with ethanol precipitation. Gene variants carrying point nucleotide substitutions — IL-1 β (–511) in the C / T promoter region. In our study, the relationship of pro-inflammatory cytokines with pathological T / T and C / T genotypes of IL - 1β 511 (rs16944) was established. It should be noted that patients with IL-1β 511 gene polymorphism (rs16944) had frequent anginal attacks, cases with ST segment elevation and depression, or T wave inversion. Patients with the T / T genotype were mostly included in the group of patients with high depression and hard to treat.

  Zarina Nasyrova, Eleonora Tashkenbaeva, Mo'min Rofeyev , Aziza Khaidarova, Farangiz Safarova

  85-90

  106   18

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  CLINICAL AND IMMUNOLOGICAL FEATURES OF THE COMBINATION OF BRONCHIAL ASTHMA AND CHRONIC OBSTRUCTIVE LUNG DISEASE The study was conducted on the basis of the Samarkand city medical association. We examined 80 patients with a diagnosis of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Bronchial asthma (BA) and Chronic obstructive pulmonary disease (COPD). Among them, the male gender prevailed and amounted to 51 (63.75%), women, respectively, were 29 (36.25%). Patients were randomized into 3 groups: group 1 comprised 27 (33.75%) patients with BA, group 2 27 (33.75%) patients diagnosed with COPD and 26 (32.5%) patients had a combination of these two diseases. In COPD and BA , changes in the immune system occur, which differs significantly from each other, primarily due to a significant increase in the content of cytotoxic lymphocytes in the blood of patients with COPD.

  Aziza Nasirova , Zuhra Kurbanova, Nodira Shonazarova

  81-84

  71   28

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  INFLUENCE OF BEDAQUILINE ON THE EFFECTIVENESS OF COMPLEX TREATMENT OF TUBERCULOSIS OF THE RESPIRATORY SYSTEM The problem of treating patients with multidrug-resistant tuberculosis (MDR-TB) has been one of the world's leading problems in the field of Phthisiology since the early 2000s. In 2013, the world health organization approved bedaquiline as a new antimicrobial drug with a new mechanism of action. The aim of the work was to evaluate the possibility of improving the clinical effectiveness of treatment of respiratory tuberculosis by prescribing the drug bedaquiline. The presented results were obtained on the basis of dynamic observation and treatment of 58 patients with drug-resistant tuberculosis of the respiratory system who were treated in the Samarkand regional TB dispensary from 2017 to 2020. Positive efficacy when using the drug bedaquiline (stopping the release of mycobacteria and closing the decay cavity) was noted in newly identified patients with infiltrative pulmonary tuberculosis and disseminated pulmonary tuberculosis. Administration to patients who have not previously taken the drug bedaquiline can reduce the clinical symptoms of the disease, significantly reduce the inflammatory process and the volume of the decay cavities.

  Nargiza Mamatova

  77-80

  71   19

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  POTENTIAL RISK FACTORS IN THE DEVELOPMENT AND PROGRESSION OF NONSPECIFIC INTERSTITIAL PNEUMONIA Currently, the interest of a number of domestic and foreign researchers in the problem of timely diagnosis and treatment of respiratory diseases has sharply increased. Nonspecific interstitial pneumonia (NPSI) was considered an orphan disease. Currently, there is a significant increase in this pathological condition, in particular, it is associated with the coronovirus pandemic, where interstitial pneumonia is a serious complication. The prevalence of NSAIDs is approximately the same as that of ILF. The prevalence of NSIPs is about 40 patients per 100 thousand people. Potential risk factors include viruses, smoking, diabetes mellitus, gastroesophageal reflux, organic and inorganic dust, heredity, etc. With NSAIDs, chronic inflammation and persistent viral infections can synergistically support autoimmune lesions that were previously described as ILF / idiopathic fibrosing alveolitis. However, causative antigens in NSIP remain unknown.

  Olga Ibadova, Nargiza Makhmatmuradova, Zuhra Kurbanova

  72-76

  104   19

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  STATE OF THE CARDIORESPIRATORY SYSTEM IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY (REVIEW) Hypertrophic cardiomyopathy is the most common hereditary heart disease, the prevalence of which is estimated at 1 in 500 in the general population. This autosomal dominant disease is characterized by thickening of the wall of the left and occasionally right ventricle. The use of cardiorespiratory stress testing helps in assessing the severity of chronic heart failure and the functional capabilities of patients with hypertrophic cardiomyopathy, to predict the risks of cardiorespiratory complications of the disease and identify mechanisms of functional limitations. This article describes in detail the functional ability and stress tests of the cardiorespiratory system in hypertrophic cardiomyopathy. Cardiorespiratory stress testing provides a non-invasive and safe approach for assessing the functional state of the cardiorespiratory system in patients with hypertrophic cardiomyopathy, helping to understand the main pathophysiological mechanisms of the course of the disease. This non-invasive assessment method allows you to stratify a patient with hypertrophic cardiomyopathy in relation to the risks of cardiovascular mortality and morbidity, as well as timely refer to specific treatment methods.

  Leo Bockeria, Lyudmila Glushko

  16-22

  52   32

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  MODERN APPROACHES TO TREATMENT OF PATIENTS AFTER EMERGENCY CORONARY INTERVENTIONS In the article modern questions of treatment after percutaneous coronary intervention at ischemic heart disease and conducting these patients from the point of view of modern requirements and clinical recommendations are considered. Efficiency of antiaggregant and hypolipidemic therapy in patients with stable CHD who underwent planned DES-stenting of coronary arteries is estimated. Patients with stable angina pectoris (SS) of III-IV functional classes (FC) of the Uzbek population (average age 57.3±6.5 years, duration of the disease on the average 5.4±1.2 years) were under observation. According to the indications, a planned coronaroangiography was performed with subsequent implantation of DES-stents on GE OPTIMA angiography unit (USA). As the results of the study showed, the timely use of modern means to control platelet aggregation, lipid metabolism in the use of basic drugs, which include aspirin, clopidogger, statins, individualized approach, taking into account pharmacogenetic studies to treat patients with CHD undergoing stenting, increases the safety and efficiency of treatment.

  Bakhrom Alyavi , Akbar Abdullayev, Djamol Uzokov , Dilbar Dalimova, Narina Raimkulova, Sherzod Iskhakov, Shuhrat Azizov, Dildora Karimova , Begzod Toshev, Dildora Islamova

  59-66

  119   36

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  CARDIOMETABOLIC RISK REDUCTION AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY According to statistical data, published in New England Journal of Medicine, Republic of Uzbekistan is leading among the countries of the Central Asia by number of people with excessive weight – they are 44,5 %, and 20,4 % of them are with superobesity. Surgical bariatric treatment of obesity is the unique method which has proved stable efficiency in reduction of excessive weight at patients with morbid obesity for a long time. The purpose of this study was evaluation of cardiometabolic risk regression after laparoscopic sleeve gasterectomy (LSG). There were observed 35 women with morbid obesity. It was established that cardiometabolic risk reduced after LSG because number of women with average risk by CMDS is reduced in 2 times, with low risk is increased in 1,6 times 12 month after surgery. Level of proinflammatory cytokine IL-6 and CRP start declining at earlier period after LSG. Volumetric - linear parameters of heart change synchronously with reduction of excessive weight and is proportional to changes of a surface of a body.

  Feruz Nazirov , Zarina Khaybullina , Shukhrat Khashimov, Nodira Sharapov, Ulugbek Makhmudov , Saodat Abdullaeva

  54-58

  83   24

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  ANTAGONISTS OF ENDOTHELIN RECEPTORS IN THE PATHOGENETIC TREATMENT OF PULMONARY ARTERIAL HYPERTENSION (REVIEW) Theoretical aspects of the using of endothelin receptor antagonists in the pathogenetic treatment of pulmonary hypertension are investigated. A comparative analysis of selective and non-selective endothelin receptor antagonists in the treatment of pulmonary arterial hypertension is performed. Special attention is paid to the role of endothelin in the pathogenesis of pulmonary hypertension. The pharmacodynamic and pharmacokinetic features of individual representatives of endothelin receptor antagonists, such as bosentan, ambrisentan and macitentan, the effect of these drugs on clinical symptoms, hemodynamic parameters, and load tolerance were studied.

  Umida Usmanova , Dilnora Yusupalieva

  51-53

  42   11

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  THE MODERN CONCEPT OF PROPHYLAXIS AND SURGICAL TREATMENT OF STERNOMEDIASTINITIS AFTER CARDIAC SURGERY Complete longitudinal median sternotomy (CLMS) is standard access not only to the mediastinum during cardiovascular surgery on the heart and main vessels, but also on thoracic surgery - 2 sided operations on the lungs, large airways. Despite the long history of the use of PPSS, it is not without drawbacks: inconsistency of the sternum sutures, diastasis of the sternum, complete instability of the bone skeleton of the chest, fragmentation of the sternum. All this can take place to develop both in isolation and against the background of the development of infection. One of the costly, from all sides, complex and formidable complications after cardiac surgery is sternal infection. This article deals in detail with sternal infection, describes in detail the diagnosis, treatment and prevention of sternal infection. Undoubtedly, in the clinical conditions of interaction in the system “organism-pathogenic microflora”, an equally important component joins - a medical institution and medical personnel, which often greatly change the natural course of events. In this regard, the issue of preventing the development of sternal infection in cardiac surgical patients after heart surgery remains relevant.

  Feruz Turaev , Ikrom Mirxodjaev

  40-50

  261   37

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  GENETIC RISK FACTORS FOR THE DEVELOPMENT OF UNSTABLE ANGINA PECTORIS IN YOUNG MEN. (REVIEW). Currently, in a number of developed countries, thanks to the implementation of programs aimed at identifying risk factors for cardiovascular diseases and eliminating them, it has been possible to achieve some reduction in the incidence and mortality from coronary heart disease. However, attempts to reduce the incidence of the cardiovascular system only by correcting environmental risk factors are not always effective. In this connection, in order to solve the problem of preventing cardiovascular diseases at the population and individual levels, the study of the molecular genetic basis of diseases of the cardiovascular system and the search for genetic risk markers of IHD and its clinical forms is relevant. This article describes the normal structure and mutation of the interleukin 1 C (+3953) T and interleukin 10 A-1082G genes in unstable angina pectoris in young men. A better understanding of the causes and mechanisms of the development of NVS in young patients is a serious medical and social task. Early diagnosis, followed by a timely and personalized approach to therapy, improves the prognosis of cardiovascular diseases at a young age.

  Eleonora Tashkenbaeva, Farida Xasanjanova

  35-39

  81   12

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  MEDICAL AND PSYCHOLOGICAL REHABILITATION: CRITERIA AND METHODS OF ORGANIZATION, FACTORS THAT ARE INFLUENCING ON THE PROCESS OF RECOVERY OF PATIENTS WITH CORONAVIRUS INFECTION. (REVIEW) Psychological rehabilitation is an integral component of a holistic system of medical rehabilitation, but in practice, as a rule, only individual rehabilitation methods are used. During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate, and about one third reported moderate anxiety. Rapid transmission of coronavirus and high mortality rates can increase the risk of mental health problems and aggravate existing psychiatric symptoms, which will further impair daily functioning and cognitive function. This article describes the psychological rehabilitation of patients with suspicion and confirmation of COVID-19, which will allow you to prematurely identify psychological problems (depression, anxiety, lack of motivation, etc.) that can serve as an obstacle to performing physical exercises, including breathing, necessary for secondary prevention of formidable pulmonary complications.

  Tatyana Pomitkina, Zilola Mavlyanova

  30-34

  88   37

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  CHANGES IN THE CYTOKINE STATUS WITH STABLE ANGINA (REVIEW) This review summarizes the current evidence on the role of cytokines in the pathogenesis of ischemic myocardial damage. It described the important role of inflammation in the development of coronary heart disease. The role of individual cytokines in the pathogenesis of coronary artery disease and the most frequent forms of it - angina. It is shown that in patients with coronary heart disease progression of the disease is due to an imbalance in cytokine system, elevated pro-inflammatory cytokines (TNF, IL-1β, IL-6). Anti-inflammatory cytokines (IL-4, IL-10) inhibit the secretion of proinflammatory cytokines by limiting excessive intensity of the immune response. Revealed increasing levels of TGF-β1 as a key cytokine that promotes the development of fibrosis in the wall of the heart and blood vessels. The interrelation between improving markers of inflammation and the development of coronary heart disease, the predictive value of these markers of inflammation in patients with stable coronary heart disease: angina of effort of different functional classes.

  Anis Alyavi, D. Tulyaganova, S. Nuritdinova, T. Khan, G. Nazarova, Sh. Saidov

  23-29

  80   33

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