CURRENT POSSIBILITIES FOR IMPROVING THE DIAGNOSTIC ALGORITHM AND OUTPUT FORECASTING OF ISCHEMIC STROKE
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11591Keywords:
sympathoadrenal system, receptor, diagnostics, membrane, reactivityAbstract
The article presents the results of a study of the functional state of the sympathoadrenal system in patients with ischemic stroke (IS). New diagnostic and prognostic criteria of the disease based on the identified changes have been developed.
The aim – to improve the diagnostic algorithm for the diagnosis of patients in the acute period of IS taking the peculiarities of changes in β-adrenergic activity of cytoplasmic membranes (ARM) of erythrocytes and establishing new prognostic factors.
Material and Methods. The work was based on the materials of a comprehensive examination of 350 patients with the first in the life of IS on the 1st, 10th and 21st day of the disease. The severity of the condition and the degree of neurological deficit were objectified using the stroke scale of the National Institutes of Health (NIHSS). There were 2 clinical groups: group 1 (n=183) – patients in a state of moderate severity (mean score on the NIHSS scale 11.74±0.33); group 2 (n=167) – patients with severe IS (average score on the NIHSS scale 24.06±0.29). Measurements of complex dielectric constant (CDC) were performed by EHF dielectrometry. Changes in the osmotic resistance of erythrocytes (ORE) under the action of β-blocker (β-AB) were determined by photoelectron colorimetry.
Results. In the debut of IS there is a significant increase in the values of β-ARM in 2.4 times compared with the control. Maximum levels of β-ARM (42.43±3.64 IU) were observed in patients with initially severe disease, which indicates significant stress on the sympathoadrenal system in these patients.
The study was the first to develop an informative, comprehensive approach to the evaluation of peripheral blood erythrocytes in patients with IS, which is based on the analysis of changes in their dielectric characteristics and the degree of ORE under the action of adrenergic drugs.
Conclusions. The application of this approach showed that the deviation of CDC of erythrocytes that were induced by adrenergic substances is a manifestation of a specific response of cells and depends on the functional state of the sympathoadrenal system.
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