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Клинико-функциональная оценка церебрального сосудистого ремоделирования у пациентов с гипертонической болезнью

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-
-
14.01.04 14.01.11
2015
,
,
-
;
,
12.00
http://www.ulsu.ru
http://vak.ed.gov.ru.
_______________
-
2
Silambarasan T. et al., 2014].
Silambarasan T. et al
Zhou M., 2014; Tocci G.et
al., 2014; Wu H. et al., 2014; Gupta S. et al., 2015].
[
Tocci G et al., 2014; Wu H. et al., 2014; Gupta S. et al.,
2014].
-
2008; Mancini A et al., 2014]
Buljian K. et
al., 2007; Siegler J.E. et al
2009; Belova L. et al, 2014].
;
Elkins J.S. et al., 2005].
.
-
-
1.
-
3
2.
I-III
3.
I-III
4.
I-III
I
III
I-III
II-III
II-III
,
.
I-II
I-III
II-III
I
-
I
I
-
I-III
4
-
I
.
1.
I
I-III
2.
II-III
-
3.
I
-
16-
Nexus Medicus
48-
-
-
119
50
186
121
65
5
-
-
, 38 (27,1 %)
%)
.
I, II, III
-
53 (37,9
I-III
(
I
II
-
III
,
-
,
I
II
III
.
1
6
1)
1
In(%)
-
-
n(%)
64 (86,5)
40 (54,1)
16 (21,6)
5 (6,8)
30 (40,5)
19 (25,7)
56 (84,8)
39 (59,1)
15 (22,7)
5 (7,6)
25 (37,9)
19 (28,8)
9 (12,2)
7 (10,6)
16 (21,6)
15 (22,7)
-
-
2.
2
n (%)
3 (5,9)
n (%)
3 (5,9)
n (%)
3 (7,9)
10 (19,6)
11 (21,6)
10 (26,3)
13 (25,5)
22 (43,1)
4 (7,8)
7 (13,7)
25 (49,0)
21 (41,2)
23 (45,1)
-
* - p < 0,05
10 (19,6)
38 (74,5)*
9 (17,6)
6 (11,7)
36 (70,6)*
31 (60,8) *
20 (39,2)
II III
8 (21,1)
31 (81,6)*
5 (13,2)
5 (13,2)
27 (71,1)*
27 (71,1)*
17 (44,7)
c
(
)
31(22,1%
II
-
III
(1,12)
18(12,9%)
II-III
7
p < 0,05).
2).
-
II-III
.
-
36 (94,7%)
p
III
II
II-III
(
,
(38(100%)
(
,
.
SF-36 (Medical
Outcomes Study 36-Item Short-Form Health Survey MOS SF-36) (John E. Ware, The Health
Institute, New England Medical Center, Boston, Massachusetts, 1992).
PF
RP
BP
GH
VT
SF
RE
MH
PCS
MCS
-
;
[Radloff, 1977]
(
CES-D (Center for Epidemiological Studies Depression Scale)
MFI-20
(Multidimensional
Fatigue Inventory
Smets E.M. et al
-
.
-
SS 8
-
.
SV
O -
Ve/Va).
)
),
-
(
)
].
Viamo SSA-640A
Toshiba
-
min
med
max
Vvolmax
-
Viamo SSA-640A
Toshiba
IR, PI
-
.
D
D
(
D
D
9
-
%; 75
% (p < 0,05).
I III
68(91,9%
63(95,4%
31(45%
(p
I
21(87,5%)
(p
14(19%
2(93,9%)
(28(37,8%)
25(46,3%)
23(42,5%)
II-III
I
.
II
].
53(80,3%)
),
5(22,7%)
25(33,8%
13(17,6%
11(14,9%)
(p
10
(p
(p < 0,02),
III
.
34(89,5%)
21(55,3%)
17(44,7%)
8(21,1)
11(28,9%)
31(81,6%)
I
30(58,8%
23(45,1 %
24(47,1 %
21(41,2 %
19(37,3 %
).
I
7(13,7 %)
II
5(9,8 %)
11(21,6 %)
38(74,5 %)
.
III
:
20(52,6 %)
19(50,0 %)
37(97,4 %)
-
I
III
I II
I
[
.
Vellante F. et al
1, 2).
120
120
100
100
80
80
60
60
40
40
20
20
0
0
1.
2.
11
(p < 0,01)
.
3, 4).
3.
4.
0RE, MH, MCS, PCS
I
p < 0,04), GH, RP, PF
BP VT
II
.
-
9[24; 36]
1[21; 28]
)
-
(1
(p < 0,04)
(p < 0,05)
)
(p>0,05).
9[35; 43]
40[36; 43]
39,7[36; 42]
(33,2[32; 39]
I
(p < 0,05)
(p>0,05).
[32; 39,5]
I
(20,7[16; 22]
1[18,5; 27]
(14,8[12; 19]
II
III
I
12
(17,7[17;
(21,5[19; 22]
)
I
(p>0,05).
5, 6).
5.
6.
I
III
7, 8).
7.
8.
I
13
II
III
(22,6[21; 25]
)
I
-
(p < 0,03).
(18,3[16,1; 20,5]
[18; 24]
II-III
14,8]
[139,4; 151,6]
(13,4[10,5; 16,4]
[106,2; 149,4]
(13,2[11,0;
,
.
I-
3).
3
II
n (%)
5 (18,5)
4 (14,8)
18(66,6)*
III
n (%)
5(20,8)
4(16,6)
15(62,5)*
3(15)
4(20)
13 (65)*
3(16,7)
4(22,2)
11(61,1)*
* - p < 0,05
II-III
.
.
(
)
.
(1,1[0,8; 1,4])
1,4]
[72,5; 81,5]
(85,9[85,4; 95,7])
(p
.
Ve/Va
II-III
(1,26[1,0;
I
II-III
14
I-III
I-III
4).
4
Vmax,
/
Vmin,
/
.
-
-
-
I
84,6
84,3
(70,3;
(69,7;
92,5)* 97,6)*
77,1
79,3
(64,7;
(63,1;
90,2)* 92,5)*
81,6
80,5
(61,7;
(63,0;
86,9)* 90,2)*
97
86,4
(80,1;
(73,2;
115,4) 90.1)*
80,7
82,3
(64,7;
(66,1;
92,6)* 90,5)*
81,7
80,9
(60,2;
(63,8;
93,5)* 91,3)*
96,7
(85,7; 115,9)
Vmed,
/
.
-
-
21,8
22
(14,5; (15,0;
30,2) 29,1)
21,7
21,9
(14,7; (14,8;
32,7) 31,6)
21,6
21,6
(15,1; (15,8;
32,6) 32,0)
23,2
22,9
(13,2; (13,7;
33,6) 32,5)
22,6
22,2
(14,2; (13,9;
31,6) 31,2)
22,1
22,1
(13,8; (13,8;
31,6) 32,0)
24,5
(17,4; 30,4)
42,4
42
(31,6; (37,1;
50,2) 51,9)
41,4
41,3
(32,8; (33,6;
50,1) 51,1)
40,7
41
(38,2; (33,7;
49,1) 52,7)
45,4
43,7
(37,4; (35,4;
52,7) 50,3)
41,1
41,2
(35,6; (33,7;
50,1) 51,7)
40,8
41
(32,0; (33,1;
50,5) 49,7)
46,6
(42,4; 50,3)
Vvolmed,
/
.
-
Vvolmax,
/
.
-
Vvolmin,
/
.
-
239,0 239,1
(175,3; (155,0;
302,8)* 308,5)*
239,1 230,4
(169,3; (146,2;
300,6)* 300,4)*
230,4 234,3
(157,9; (160,4;
305,2)* 310,2)*
265,3 236,6
(189,3; (158,4;
330,4) 308,3)*
248,9 234,6
(168,4; (162,5;
300,9)* 305,2)*
249,4 239,7
(168,8; (166,9;
307,4)* 303,4)*
263,9
(180,2; 338,6)
482,7 484,1
(347,8; (358,0;
540,4)* 532,7)*
488,4 485,7
(349,1; (351,3;
558,9)* 538,5)*
493,5 490,1
(352,6; (361,7;
589,4)* 548,5)*
549,6 499,7
(421,1; (369,7;
613,8) 512,7)*
534,7 491,4
(419,4; (360,8;
600,4)* 524,6)*
525,9 494,7
(409,8; (367,3;
593,6)* 517,6)*
563,4
(444,7; 668,2)
104,3 103,9
(89,4; (86,7;
115,3) 110,8)
104,1
104
(90,3; (86,7;
110,4) 112,7)
105
105,2
(83,6; (89,4;
109,5) 117,8)
100,2 101,2
(82,4; (82,3;
110,6) 112,6)
102,6 102,9
(80,4; (86,7;
111,6) 115,8)
101,5 102,6
(81,6; (84,2;
113,7) 116,4)
93,2
(83,9; 116,7)
* p < 0,05
,
,
4).
5).
5).
15
5
Vmax,
/
Vmin,
-
-
I
/
Vvolmed,
-
74,8
74,0
(68,9;
(67,2;
79,2)*
80,0)*
72,0
71,8
(65,4;
(66,7;
78,6)*
77,4)*
61,8
62,4
(55,9;
(56,8;
69,3)*
71,3)*
77,4
75,1
(68,3;
(69,6;
85,7)*
80,8)*
73,2
72,8
(65,1;
(66,0;
81,7)*
78,5)*
70,3
67,4
(63,9;
(60,3;
78,5)*
74,9)*
83,7 (75,2; 90,9)
/
-
Vvolmax,
/
Vvolmin,
-
21,8
21,8
254,5
260,1
271,75
282,1
(17,2;
(17,8; (187,4; (188,9; (178,5; (182,7;
25,8)* 25,1)* 322,7)
330,7) 346,9)* 365,2)*
25,0
24,8
270,1
271
271,9
279,7
(19,4;
(19,6; (196,9; (191,4; (164,3; (181,4;
29,7)* 29,2)* 325,1)
335,7) 359,8)* 357,2)*
22,2
21,4
260,4
262,3
273
270,1
(18,6;
(16,7; (180,4; (180,6; (165,9; (169,9;
26,5)* 26,3)* 311,2)
320,5) 348,7)* 360,7)*
24,7
22,5
277,3
261,3
305,8
283,5
(19,7;
(20,6; (188,8; (197,2; (202,7; (201,7;
29,7)* 31,4)* 345,1)
333,7)
384,9) 344,9)*
25,3
24,8
268
270,7
281,9
281,4
(20,0;
(20,8; (194,7; (198,5; (202,7; (200,0;
29,4)* 28,9)* 320,3)
329,7) 369,7)* 356,0)*
24,7
22,0
271,3
265,8
279,7
271,8
(18,6;
(18,5; (194,6; (190,5; (199,3; (183,6;
28,9)* 27,4)* 338,5)
330,4) 339,1)* 328,5)*
32,4 (27,6; 41,9) 270 (190,2; 341.4) 310,7 (200,6; 405,2)
/
-
90,3
92,6
(71,4;
(73,5;
106,9) 108,3)
100,7
100
(81,9;
(82,5;
118,3) 113,7)
100,9
101,8
(83,2;
(85,2;
117,7) 116,7)
99,4
101,5
(86,3;
(83,6;
113,7) 114,1)
101,7
102
(85,9;
(89.3;
116,3) 114,6)
101,1
101,5
(85,2;
(85,7;
115,9) 116,3)
92,1 (80,4; 113,7)
* p < 0,05
6).
6
V max,
-
I
/
-
37,3
37,0
(28,4;
(32,4;
42,7)* 43,0)*
38,8
39,0
(33,9;
(33,8;
43,6)* 44,1)*
40,1
40,1
(36,8;
(35,1;
45,2)* 45,8)*
50,1
37,2
(47.0;
(32,6;
54,7)
44,3)*
50,0
38,3
(45,7;
(33,6;
56,9)
45.0)*
40,4
40,3
(35,7;
(35,8;
45,9)* 45,0)*
56,4 (51,4; 62,3)
*
V min,
/
-
15,3
15,6
(9,5;
(10,5;
21,6)* 20,4)*
12,0
12,0
(7,3;
(7,2;
19,3)* 18,7)*
14,3
15,0
(8,0;
(8,9;
19,6)* 20,2)*
18,6
15,6
(12,4;
(10,6;
23,5)
21,6)*
17,8
12,4
(11,8;
(7,6;
22,4)
19,4)*
15,5
14,8
(9,1;
(7,2;
22,4)* 20,1)*
19,7 (13,3; 24,6)
p < 0,05
16
Vvolmed,
/
-
Vvolmax,
/
-
54,5
50,1
85,3
85,7
(31,7;
(25,8;
(35,2;
(34,6;
78,3)
68,4) 134,7)* 136,8)*
50,1
51
95,2
95,6
(28,9;
(25,3;
(43,7;
(50,0;
72,1)
70,5) 135,8)* 141,2)*
50,4
52,3
101,6
101,1
(26,9;
(27,7;
(52,4;
(51,8;
73,1)
71,6) 146,8)* 150,7)*
47,3
51,3
110,3
85,1
(26,4;
(28,4;
(49,2;
(38,0;
68,7)
70,0)
161,4) 100,5)*
48
50,7
108,9
96,2
(24,7;
(27,9;
(57,6;
(40,4;
66,9)
71,7)
159,2) 109,4)*
51,3
45,8
101,7
100,3
(27,1;
(23,5;
(53,1;
(39,7;
69,7)
68,3) 150,3)* 135,9)*
49,3 (27,4; 68,3) 120,4 (61,4; 184,4)
Vvolmin,
/
-
20,3 22,6 (5,8;
(6,9;
30,3)
31,5)
20,7
20,0
(5,0;
(8,0;
34,6)
32,7)
20,9
21,8
(5.1;
(5,3;
33.7)
32,7)
29,4
21,5
(14,7;
(5,9;
39,3)
32.1)
21,7
22,0
(7.5;
(8,7;
36,8)
33,9)
21,1
21,5
(7,3;
(6,9;
38,4)
32,0)
22,1 (9.4; 36,5)
I-III
>
).
I-III
(133,7[110,8; 155,2]
62,5[52,3; 74,8]
92,5[86,4; 100,3]
(131,7[111,5; 151,9
),
51,3; 72,1
70,1; 89,9
.
I-III
Vmax
Vmax
Vmin
Vmin
(
),
,05)
[10,2; 16,4]
[5,1; 9,7]
, (p < 0,002)
I-III
-
-
[14,3; 17,6]
[8,9; 26,4]
[366,9; 485,7]
49,4[28,7; 68,3]
, 23,8[17,6; 29,0]
-
[412,0; 631,4]
49,4[28,7;
68,3],
23,8[17,6;
29,0],
523,9
[412,0;
631,4]
I-III
Vmax, Vmin Vmed
III
16,5[16,0; 16,9], 9,7[9,0; 10,3], 24,6[14,6; 34,5]
17
I-III
II-III
RI, PI, Vmax, Vmin
I
(RI, PI)
-
.
-
(RI, PI, Vmax, Vmin)
II-III
(Vmax, Vmin)
.
-
(RI
PI)
II-III
I-III
1
7).
-
7).
7
1n (%)
25 (92,6)
23 (95,8)
70-
n (%)
27 (100)
24 (100)
n (%)
19 (95)
18 (100)
n (%)
11 (41)*
20 (83,3)
n (%)
23 (85,2)
22 (91,7)
n (%)
17 (83,3)
16 (88,9)
*
9, 10).
II-III
18
14
12
10
8
6
4
2
0
9.
10.
(Vmax Vmin
Vmax Vvol max
I, II
Vmax
Vmin
19
III
Vmax
Vmin
Vmin
1.
I
III
2.
I
I-III
3.
II-III
I
4.
III
-
-
I
II-III
5.
I-II
I-III
II-III
-
6.
I-III
I
-
20
I
I-II
I-III
1.
2012.
2.
26.
URL:
2012.
http://www.science-education.ru/105-7239.
3.
-
2013.
4.
36.
-
-70.
5.
2014.
-
2014.
6.
/
-
-8. -
-9.
-
2013.
7.
-
-
21.
-
2013.
31.
8. Kolotik-Kameneva O. Central haemodynamics in patients with chronic cerebral
ischemia and constitutional venous insufficiency [Text] / O. Kolotik-Kameneva [et al.] // The 2nd
International conference on Heart and Brain : program book. Paris, 2014. P. 228.
9. Kolotik-Kameneva O. Heart haemodynamics in chronic cerebral ischaemia (CCI) [Text]
/ L. Belova., V. Mashin, N. Belova, O. Kolotik-Kameneva [et al.] // The 2nd International
conference on Heart and Brain : program book. Paris, 2014. P. 229.
10.
Kolotik-Kameneva O. Type of headache in patients with chronic cerebral
ischemia [Text] / L. A. Belova, V. V. Mashin, Yu. M. Nikitin, N. V. Belova, O. Yu. Kolotik-
21
Kameneva // Abstr. of The 6th World congress on controversies in neurology. Vienna, 2012. P.
84.
11.
Kolotik-Kameneva O. Cytoflavin effect on venous component of cerebral
haemodinamics in patients with chronic cerebral ischemia and constitutional venous insufficiency
[Text] / O. Kolotik-Kameneva, L. Belova, V. Mashin [et al.] // European Journal of Neurology.
2012. Vol. 19. P. 523.
12.
Kolotik-Kameneva O. Sleep disorders in patients with chronic cerebral ischemia
[Text] / L. Belova, O. Kolotik-Kameneva [et al.] // Abstr. of 16 th Congress of the European
federation of neurological societies. Stockholm, 2012. . 86.
13.
Kolotik-Kameneva O. MRI in chronic cerebral ischemia [Text] / L. Belova, O.
Kolotik-Kameneva [et al.] // Abstr. of 16th Congress of the European federation of neurological
societies. Stockholm, 2012. . 86.
14.
15.
XIV
14.
-
X
2012.
16.
21.
-
17.
-
122 123.
18.
-
19.
-
. 399.
20.
-
-
-
21.
-
22.
-
22
-
343.
23.
-
.
24.
-
25.
-
2014.
26.
-
23
-
24
-
BP
D
CO
GH
IR
N
NO
MCS
MH
PCS
PF
PI
RE
RP
SF
S
SV
Va
-
V max
V med
V min
V volmax
Vvolmed
V volmin
VT
25
1/--страниц
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