193
УДК: 616.316.7-007.14:611.018.74] - 612.313.5
https://doi.org/10.34920/min.2021-3.027
EVALUATION OF THE FUNCTIONAL STATE OF VASCULAR ENDOTHELIAL CELLS
IN PATIENTS WITH REACTIVE DYSTROPHIC DISEASES OF THE SALIVARY
GLANDS
L.R. Jumaev, S.J. Hamraev
Bukhara State Medical Institute, Republic of Uzbekistan, Bukhara
ABSTRACT
Due the fact that in 70% of cases of admission of patients with diseases of the salivary glands,
the correct diagnosis causes significant difficulties, this issue remains an urgent problem of modern
medicine. The aim of this study is to study the anticoagulant and fibrinolytic properties of the
vascular wall endothelium, as well as to determine the markers of endothelial dysfunction -
homocysteine and endothelin in patients with reactive dystrophic diseases of the salivary glands.
This article presents the results of a survey of 64 patients with reactive dystrophic diseases (RDD)
and inflammatory diseases of the salivary glands (SG) at the age of 20 to 55 years. As a result, it
found that, in contrast to healthy individuals, there is an increase in the serum content of not only
homocysteine, but also endothelin I. The obtained data allow us to conclude that in patients of this
category there are significant violations of the vascular wall thrombosis resistance, which manifested
by changes in the anticoagulant and fibrinolytic properties of the endothelium. It also found that in
this pathology, there is an increase in the serum content of not only homocysteine, but also
endothelin I.
Key words:
salivary glands, reactive dystrophic diseases, sialadenosis, oral fluid, endothelial
cells, nitric oxide.
194
ОЦЕНКА ФУНКЦИОНАЛЬНОГО СОСТОЯНИЯ ЭНДОТЕЛИАЛЬНЫХ КЛЕТОК
СОСУДОВ У БОЛЬНЫХ С РЕАКТИВНО-ДИСТРОФИЧЕСКИМИ
ЗАБОЛЕВАНИЯМИ СЛЮННЫХ ЖЕЛЕЗ
Л.Р. Жумаев, С.Ж. Xамpаeв
Бухарский государственный медицинский институт
АННОТАЦИЯ
По причине того, что в 70% случаев поступления больных с заболеваниями слюнных
желез, постановка правильного диагноза вызывает значительные затруднения, этот вопрос
остается актуальной проблемой современной медицины. Целью данного исследования
является изучение антикоагулянтных и фибринолитических свойств эндотелия сосудистой
стенки, а также определение маркеров эндотелиальной дисфункции - гомоцистеина и
эндотелина у больных с реактивно-дистрофическими заболеваниями слюнных желез. В
данной статье
приведены
данные
обследования
64
больных
с
реактивно-
дистрофическими заболеваниями (РДЗ) и воспалительными заболеваниями слюнных
желез (СЖ) в возрасте от 20 до 55 лет. В результате установлено, что при РДЗ СЖ, в
отличие от здоровых лиц, происходит увеличение содержания в сыворотке крови не только
гомоцистеина, но и эндотелина I. Полученные данные позволяют заключить, что у больных
данной категории происходят значительные нарушения тромборезистентности сосудистой
стенки, которые проявляются изменением антикоагулянтных и фибринолитических свойств
эндотелия. Также установлено, что при данной патологии происходит увеличение
содержание в сыворотке крови не только гомоцистеина, но и эндотелина I.
Ключевые слова: слюнные железы,
реактивно-дистрофическими заболевания, сиаладенозы,
ротовая жидкость, эндотелиальных клеток, оксида азот
.
Relevance.
The endothelium - the inner lining of blood vessels - takes an active part in the
regulation of vascular tone, producing various biologically active substances (BAS). BAS, which act
on the endothelium, are produced by platelets, white blood cells, mast cells or are activated in the
blood plasma, some of the substances are synthesized in the endothelium itself and act on
endothelial cells either after they are excreted into the bloodstream, or paracrine. The effect on
endotheliocytes of BAS is associated with the presence of specific receptors on endotheliocytes, the
stimulation of which causes vasodilation or vasoconstriction [1,4,6].
In endothelial dysfunction (ED), the functional state of the internal lining of the vessels is
disturbed, which leads to the production of an excessive amount of nitric oxide (NO) [3,5]. Large
amounts of NO in the blood can form peroxynitrite, which activates the process of free radical
oxidation of proteins and lipids. Therefore, one of the reasons for the violation of regional blood
circulation and microcirculation is endothelial dysfunction, which can lead to vascular spasm,
increased thrombosis and increased adhesion of white blood cells to the endothelium. Nitric oxide is
195
involved in the regulation of almost all endothelial functions (regulation of vascular tone, vascular
thrombosis resistance), and is also the most sensitive factor to damage [6,7].
Endothelial dysfunction has another, no less important aspect - hemostatic disorders. As long
as the endothelium is intact, it is not damaged, it synthesizes mainly anticoagulation factors, which
are also vasodilators. In addition, the endothelium adsorbs numerous anticoagulant substances from
the blood plasma. The combination of anticoagulants and vasodilators on the endothelium under
physiological conditions is the basis for adequate blood flow, especially in the microcirculation
vessels.
With prolonged damage to the endothelium, according to many researchers, it begins to play a
key role in the pathogenesis of a number of systemic pathologies, in particular in MS. This is due to
the switching of endothelial activity to the synthesis of oxidants, vasoconstrictors, aggregates, and
thrombogenic factors. And it is platelets that are the main cells that ensure the normal course of
hemostasis, the main function of platelets is their participation in the processes of blood clotting.
The purpose of the study.
To study the anticoagulant and fibrinolytic properties of the
vascular wall endothelium, as well as to determine the markers of endothelial dysfunction -
homocysteine and endothelin in patients with reactive dystrophic diseases of the salivary glands.
Material and methods of research.
A study of 64 patients with reactive dystrophic diseases
of the salivary glands (RDD) and inflammatory diseases of the salivary glands at the age of 20 to 55
years conducted. The control group consisted of 20 practically healthy individuals.
Blood sampling performed in the morning, on an empty stomach, at rest. From the ulnar vein of one arm,
blood taken by gravity into a vacuum tube with EDTA. After sampling, the test tube placed on ice and
transported to the laboratory. The blood centrifuged for 10 minutes at a speed of 1000 revolutions per minute at
a temperature of 40
C on a Beckman coulter Allegra X-30R centrifuge. The samples were stored at a
temperature of - 20
C until the analysis carried out. Enzyme immunoassay for 49 determination of the
quantitative level of ET-1 performed using the test system Biomedical ENDOTELIN (1-21) of JSC
"Biochemmak". In addition, the activity of antithrombin III determined by the photometric method, platelet
aggregation by the method proposed in 1989 by A. S. Shitikova , fibrinolytic activity of the endothelium of the
human vascular wall [2,3].
The results of the studies were processed using the Student's T-test (t) and the
probability of error (p). At p<0.05, the differences between the two samples were considered
significant. For statistical processing of the results, we used the Microsoft Excel software
package using the data analysis package.
Results and discussion.
The obtained data indicate that the examined patients have
inhibition of anticoagulant activity of the vascular wall endothelium. In the examined
patients, there is a statistically significant decrease in the activity of antithrombin III in the
blood before and, to greater extent, after the occlusion test, as well as a decrease in the index
of anticoagulant activity of the vascular wall endothelium compared to clinically healthy
volunteers. Thus, the activity of antithrombin III in the blood before and aft er the cuff test,
the index of anticoagulant activity of the vascular wall endothelium significantly decreases
(Fig. 1).
196
Fig. 1. Indicators of anticoagulant activity of the vascular endothelium in patients with
reactive dystrophic diseases of the salivary glands
During the comparative analysis, it found that the activity of antithrombin III in the blood
before and, especially, after the occlusion test, as well as the index of anticoagulant activity of the
endothelium of the vascular wall is statistically significantly lower in patients compared to healthy
individuals. In this pathology, anticoagulant activity of the endothelium of the vascular wall, which
manifested by a decrease in endothelial secretion of antithrombin III.
When assessing the fibrinolytic activity of the endothelium of the vascular wall, it was found
that in patients with RDD of the SG , there is a statistically significant increase in the time of
Hageman-dependent fibrinolysis before and, especially, after the cuff test, compared with clinically
healthy volunteer donors.
At the same time, in the comparative groups, there was a decrease in the index of fibrinolytic
activity of the vascular wall endothelium (Figure 2), which reflects a decrease in the release of tissue
plasminogen activator by endotheliocytes and / or an increase in the production of a plasminogen
activator inhibitor.
The differences in the index of fibrinolytic activity of the vascular wall endothelium in the
examined individuals are not expressed equally and the time of Hageman-dependent fibrinolysis
before and after the cuff test is statistically significantly longer in individuals with pathology, which
Antithrombin III after the cuff test, %
115
110
105
100
95
90
85
110.2
95.4
control (healthy) patients with RDZ
Antithrombin III before the cuff test, %
88.2
90
85
79.2
80
75
70
control (healthy)
patients with RDD
Index of anticoagulant activity of the
endothelium, standard units.
1.28
1.3
1.2
1.14
1.1
1
control (healthy) patients with RDZ
197
indicates a more pronounced inhibition of fibrinolytic activity and is associated with a more
significant imbalance in the release of the tissue plasminogen activator and its inhibitor by
endotheliocytes. Consequently, the fibrinolytic activity of the vascular endothelium is higher in
RDD SG than in healthy individuals.
INDEX OF ENDOTHELIAL FIBRINOLYTIC
ACTIVITY, USL. UNITS
X11A-DEPENDENT FIBRINOLYSIS BEFORE THE CUFF
TEST, WITH
1.5
1.49
650
607.5
600
548.5
1.4
1.38
550
500
1.3
control (healthy)
Patients with RDD
control (healthy)
Patients with RDD
SG
SG
Fig. 2. Indicators of fibrinolytic activity of the vascular endothelium in patients with
CGP-associated MS
Thus, as a result of the conducted studies, it was found that in RDD SG, changes in the fibrinolytic
activity of the vascular wall endothelium occur, which are manifested by a decrease in the induced
release of the tissue plasminogen activator and/or an increase in the release of its inhibitor. The
obtained data allow us to conclude that in patients with RDD SG there are significant violations of
the thrombosis resistance of the vascular wall, which manifested by changes in the anticoagulant and
fibrinolytic properties of the endothelium. At the same time, disorders of both anticoagulant and
fibrinolytic activity of the vascular endothelium predominate in comparison with healthy individuals
(Fig.3).
198
Figure 3. Blood homocysteine and endothelin 1 levels in patients with CGP-associated
MS
To assess endothelial dysfunction, the serum concentrations of homocysteine and endothelin
we studied in the examined patients. As result of the conducted studies, it found that the examined
patients had a statistically significant increase in the content of homocysteine in the blood serum
compared to clinically healthy volunteer donors. At the same time, in the examined patients, the
concentration of homocysteine and endothelin I in the blood serum statistically significantly higher
compared to healthy individuals.
Conclusion.
Thus, it found that in RDD SG, in contrast to healthy individuals, there is an
increase in the serum content of not only homocysteine, but also endothelin I. The obtained data
allow us to conclude that in patients of this category there are significant violations of the
thrombosis resistance of the vascular wall, which manifested by changes in the anticoagulant and
fibrinolytic properties of the endothelium. It also found that in this pathology, there is an increase in
the serum content of not only homocysteine, but also endothelin I.
Литература/References
1.
Давыдкин, И.Л. Основы клинической гемостазиологии : монография/ И.Л. Давыдкин, В.А. Кондурцев, Т.Ю.
Степанова, С.А. Бобылев. – Самара, 2009. – 436 с.
[ Davydkin, I. L. Fundamentals of clinical hemostasiology:
monograph/ I. L. Davydkin, V. A. Kondurtsev, T. Yu. Stepanova, S. A. Bobylev. - Samara, 2009 – - 436 p. (In Russ.).]
https://doi.org/10.25555/THR.2017.2.0780
2.
Диагностическое значение исследования фактора роста эндотелия сосудов в сыворотке / Н.Б. Захарова, Д.А.
Дурнов, В.Ю. Михайлов [и др.] // Фундаментальные исследования. – 2011. – №11(1). – C. 215–220.
[ Diagnostic
significance of the study of vascular endothelial growth factor in serum / N. B. Zakharova, D. A. Durnov, V. Yu.
Mikhailov [et al.] / / Fundamental Research. – 2011. – №11(1). – C. 215–220. (In Russ.).]
3.
Канищева Е.М. Возможность оценки состояния микроциркуляторного русла и стенок крупных сосудов
//Сердце: журнал для практикующих врачей. – 2010. – Том 9.– №1(51). – С. 65–70.
[ Kanishcheva E. M. The
possibility of assessing the state of the microcirculatory bed and the walls of large vessels / / Heart: journal for
practicing physicians. - 2010. - Tom 9.– №1(51). – Pp. 65-70. (In Russ.).]
4.
Киричук В.Ф. Дисфункция эндотелия /В.Ф. Киричук, П.В. Глыбченко, А.И. Понаморёва //Саратов: Изд-во
Саратовского мед.ун-та, 2008. – 140 с.
[ Kirichuk V. F. Endothelial dysfunction / V. F. Kirichuk, P. V. Glybchenko,
A. I. Ponamoreva //Saratov: Publishing house of the Saratov Medical University, 2008. - 140 p. (In Russ.).]
5.
Петрищев, Н.Н. Физиология и патофизиология эндотелия :в кн.: Дисфункция эндотелия. Патогенетическое
0.38
0.36
0.36
0.34
0.32
0.31
0.3
0.28
Endothelin I concentration, mmol / ml
control (healthy)
Patients with RDD SG
20
18.2
15
10.8
10
5
0
Endothelin I concentration, mmol / ml
control (healthy)
Patients with RDD SG
199
значение и методы коррекциипод ред. Н.Н. Петрищева/Н.Н. Петрищев, Т.Д. Власов. – Санкт-Петербург, 2007.
– С. 4–48.
[ Petrishchev, N. N. Physiology and pathophysiology of the endothelium in: Endothelial dysfunction.
Pathogenetic significance and methods of correction, ed. by N. N. Petrishchev/N. N. Petrishchev, T. D. Vlasov. - St.
Petersburg, 2007. - p. 4-48. (In Russ.).]
6.
Современные методы распознавания состояния тромботической готовности : монография /А.П. Момот,
Л.П.Цывкина, И.А.Тараненко [и др.] – Барнаул, 2011. – 138 с.
[Modern methods of recognition of the state of
thrombotic readiness: monograph / A. P. Momot, L. P. Tsyvkina, I. A. Taranenko [et al.] - Barnaul, 2011. - 138 p. (In
Russ.).]
7.
A novel echocardiographic method as an indicator of endothelial dysfunction in patients with coronary slow flow [Text]
/H. Simsek, M. Sahin, Y. Gunes[et al.] //Eur Rev Med Pharmacol Sci. – 2013. –Vol. 17(5). – Р. 689–693.
8.
Alt, E. Blood rheology in deep venous thrombosis––relation to persistent and transient risk factors [Text] / E. Alt, S.
Banyai, M. Banyai, R. Koppensteiner //Thromb Res. – 2002.–Vol.107 (3–4). – Р.101–107.
9.
Endotelial dysfunction in uremic patients on continuous ambulatory peritoneal dialysis (CAPD) [Text] / S. Rasić, A.
Hadzović-Dzuvo, D. Rebić [et al.] //Bоsnian Journal of basic medical Sciencen. – 2011. – Vol. 11 (3). – Р. 153–157.
10.
Goon, P.K. Circulating endothelial cells: markers of vascular dysfunction [Text] / P.K. Goon, C.J. Boos, G. Y. Lip //
Clin. Lab. – 2005. –Vol. 51. – Р.531–538.
УДК: 616.6 -616.381-072-089] – 614.23:617-614.252.1
https://doi.org/10.34920/min.2021-3.028
ДИНАМИКА РЕЗУЛЬТАТОВ ЛЕЧЕНИЯ УРОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ
ЛАПАРОСКОПИЧЕСКИМ МЕТОДОМ С УЧЕТОМ СТЕПЕНИ ОСВОЕНИЯ
ЛЕЧЕБНОЙ ТЕХНОЛОГИИ
Б.А.Аюбов¹, Ш.Т.Мухтаров¹, Ф.А.Акилов², Д.Х.Мирхамидов², М.М.Бахадирханов¹,
Дж.А.Назаров¹, Н.Д.Уралова¹
