23 research outputs found
Influence of physical loads of different orientation on indicators of physical working capacity and level of the maximum oxygen consumption at the qualified athletes depending on the period of training process
Objective: to assess the impact of physical activity of different orientation and intensity on the physical performance and maximum oxygen consumption (MOC) in qualified athletes, depending on the period of the training process. Materials and methods: 136 male athletes were examined, 116 of them were qualified athletes (age 22.1Β±4.1 years). I group β wrestling (n=30), II β cross-country skiing, biathlon (n=27), III β powerlifting (n=33), IV β volleyball (n=26). V β control (n=20), sports training less than 3 years. Bicycle ergometry (VEM) with the assessment of physical performance on the PWC170 test in the preparatory and competitive periods of training was conducted. STATISTICA 10.0 program was used for statistical processing. Data were presented as: median (Me), lower and upper quartiles (25% and 75%). Results: the highest rates of PWC170 β 1508.0 KGM/min and IPC β 65.37 ml/min/kg in the preparatory period and, respectively, PWC170 β 1560.0 KGM/min and IPC β 68.00 ml/min/kg in the competitive period were achieved by athletes in group II. Athletes in group III had the lowest rates of PWC170 β 1100.0 KGM/min and IPC β 40.60 ml/min/kg in both the preparatory and competitive periods β 1120.0 KGM/min and 42.04 ml/min/kg. Conclusions: high level of physical performance and MOC indicated the effectiveness of the cardiovascular system in athletes of highly dynamic sports, training for endurance (crosscountry skiing, biathlon). In powerlifters with high intensity of static loads, physical performance and MOC remained at a low level. The results can be used to make timely adjustments to the training and competitive process of athletes
Structural and functional indicators of the heart of patients with ischemic heart disease and type 2 diabetes mellitus. Rhythmoinotropic response isolated myocardium at different levels of glycated hemoglobin
BACKGROUND: Adequate glycemic control can significantly reduce the risk of developing cardiovascular events. However, until now, glycaemic targets in aged patients remain a subject of discussion, especially in the conditions of the combined development of Type 2 Diabetes Mellitus (T2DM) and ischemic heart disease (IHD).AIMS: To examine the structural and functional heart parameters in patients with IHD associated with T2DM and the rhythmoinotropic responses of their isolated myocardium depending on glycated hemoglobin level.MATERIALS AND METHODS: The study included 44 patients with a diagnosis of "chronic IHD associated with T2DM", of which 2 groups were formed. Patients with glycated hemoglobin level (HbA1c) <8% were included in the 1st group, and patients with HbA1c β₯8% were included in the 2nd group. The structural and functional heart parameters obtained with ultrasonography, and the rhythmoinotropic responses of myocardium in patients ex vivo were analyzed using the right atrial appendage fragments obtained during elective coronary artery bypass graft. The inotropic response of muscle strips at a basic stimulation frequency of 0,5 Hz to testing influences was assessed. An extrasystolic test and post-rest test were performed.RESULTS: It was found that extrasystolic contractions of isolated myocardial strips in patients of the 2nd group appeared at shorter extrasystolic intervals, which indicates a greater excitability of the myocardium in patients of this group. Postextrasystolic muscle contractions in patients of the 2nd group had significant potentiation. The amplitude of the muscle strips contractions in patients of both groups was potentiative after short rest periods. However, with an increase in the rest duration, potentiation of contractions was observed only in the group with a higher HbA1c level. According to the ultrasonography data, it was found that the values of the endsystolic and diastolic volumes, the interventricular septum thickness and the left ventricular (LV) myocardium mass were significantly lower in the patients of the 1st group compared with the corresponding indicators in the patients of the 2nd group. The early LV filling velocity (peak E) was significantly lower in the patients of the 1st group, which indicates a slower LV relaxation. At the same time, the rapid LV filling velocity did not have a significant intergroup difference, but this indicator exceeded the reference values in both groups.CONCLUSIONS: With a moderately increased glycemic level (9,2 [8,0; 10,3]%), the structural and functional heart parameters are preserved both at the level of the isolated myocardial tissue and at the level of the whole heart
ΠΠΠΠ ΠΠΠΠ ΠΠΠ Π€ΠΠΠ’ΠΠ Π ΠΠ‘ΠΠ Π’Π ΠΠΠΠΠΠΠΠΠΠΠ ΠΠΠΠΠ§ΠΠΠ ΠΠ Π’ΠΠ ΠΠ
The aim of the study. Based on the data of the Register of new cases of hospital pulmonary embolism (PE) in hospitals in Tomsk (2003β2012), to explore the contribution of obesity to the development of venous thromboembolism.Material and Methods. Study were subjected to medical history and records of autopsies of patients treated in hospitals in Tomsk in 2003β2012, who at patologoanatomic and/or instrumental study revealed pulmonary embolism. The degree of obesity was assessed according to WHO criteria (1997). Statistical processing of the results was carried out using the software package for PC Statistica 8.0 for Windows. To test the normality of the distribution of quantitative traits using the ShapiroβWilk test and the KolmogorovβSmirnov with the adjusted Lillieforsa. Check the equality of the population variance was performed using Fisher's exact test and Cochran. Was considered statistically significant level of p < 0.05.The results of the study. In Western Siberia, Tomsk, a register of hospital pulmonary embolism (2003β2012). In the register included 720 patients with in vivo and/or post mortem revealed pulmonary embolism (PE). Analyzed data from medical records and autopsy reports. Revealed statistically significant differences in BMI (p = 0.033) and the presence of obesity (p = 0.002) in patients with pulmonary embolism, holding medical and surgical beds. As of medical, surgical and among patients with thromboembolism, obesity is significantly more common in women than men (p = 0.050 and p = 0.041 respectively). According to the study, obesity grade 1 or 2 alone (at the isolated presence of the patient) is not significantly increased the odds of a massive thromboembolism. However, grade 3 obesity increased the odds of a massive pulmonary embolism by more than 2.7 times (OR = 2.708, CI: 1,461β5,020).Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π΄Π°Π½Π½ΡΡ
Π Π΅Π³ΠΈΡΡΡΠ° Π½ΠΎΠ²ΡΡ
ΡΠ»ΡΡΠ°Π΅Π² Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ (Π’ΠΠΠ) Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
Π³. Π’ΠΎΠΌΡΠΊΠ° (2003β2012 Π³Π³.), ΠΈΠ·ΡΡΠΈΡΡ Π²ΠΊΠ»Π°Π΄ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΈ ΠΏΠΎΠ΄Π²Π΅ΡΠ³Π½ΡΡΡ ΠΈΡΡΠΎΡΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»Ρ Π²ΡΠΊΡΡΡΠΈΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π»Π΅ΡΠΈΠ²ΡΠΈΡ
ΡΡ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
Π³. Π’ΠΎΠΌΡΠΊΠ° Π² 2003β2012 Π³Π³., Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΡΠΈ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈ (ΠΈΠ»ΠΈ) ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π²ΡΡΠ²Π»Π΅Π½Π° Π’ΠΠΠ. Π‘ΡΠ΅ΠΏΠ΅Π½Ρ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΠΠ (1997). Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΎΠ±ΡΠ°Π±ΠΎΡΠΊΠ° ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΡ
ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»Π°ΡΡ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΏΠ°ΠΊΠ΅ΡΠ° ΠΏΡΠΈΠΊΠ»Π°Π΄Π½ΡΡ
ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌ Statistica 8.0 for Windows. ΠΠ»Ρ ΠΏΡΠΎΠ²Π΅ΡΠΊΠΈ Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΠΎΡΡΠΈ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
ΠΏΡΠΈΠ·Π½Π°ΠΊΠΎΠ² ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ ΠΊΡΠΈΡΠ΅ΡΠΈΠΉ Π¨Π°ΠΏΠΈΡΠΎβΠ£ΠΈΠ»ΠΊΠ° ΠΈ ΠΊΡΠΈΡΠ΅ΡΠΈΠΉ ΠΠΎΠ»ΠΌΠΎΠ³ΠΎΡΠΎΠ²Π°βΠ‘ΠΌΠΈΡΠ½ΠΎΠ²Π° Ρ ΠΏΠΎΠΏΡΠ°Π²ΠΊΠΎΠΉ ΠΠΈΠ»Π»ΠΈΠ΅ΡΠΎΡΡΠ°. ΠΡΠΎΠ²Π΅ΡΠΊΡ ΡΠ°Π²Π΅Π½ΡΡΠ²Π° Π³Π΅Π½Π΅ΡΠ°Π»ΡΠ½ΡΡ
Π΄ΠΈΡΠΏΠ΅ΡΡΠΈΠΉ ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΡΠΈΡΠ΅ΡΠΈΠ΅Π² Π€ΠΈΡΠ΅ΡΠ° ΠΈ ΠΠΎΡ
ΡΡΠ½Π°. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠΌ ΡΡΠΈΡΠ°Π»ΠΈ ΡΡΠΎΠ²Π΅Π½Ρ p < 0,05.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. Π ΡΡΠ΅Π΄Π½Π΅ΡΡΠ±Π°Π½ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ Π³ΠΎΡΠΎΠ΄Π΅ ΠΠ°ΠΏΠ°Π΄Π½ΠΎΠΉ Π‘ΠΈΠ±ΠΈΡΠΈ, Π’ΠΎΠΌΡΠΊΠ΅, ΡΠΎΠ·Π΄Π°Π½ Π Π΅Π³ΠΈΡΡΡ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ (2003β2012 Π³Π³.). Π Π Π΅Π³ΠΈΡΡΡ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 720 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΡΠΈΠΆΠΈΠ·Π½Π΅Π½Π½ΠΎ ΠΈ (ΠΈΠ»ΠΈ) ΠΏΠΎΡΠΌΠ΅ΡΡΠ½ΠΎ Π²ΡΡΠ²Π»Π΅Π½Π° Π’ΠΠΠ. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»ΠΎΠ² ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π²ΡΠΊΡΡΡΠΈΡ. ΠΡΡΠ²ΠΈΠ»ΠΈΡΡ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΡΠ°Π·Π»ΠΈΡΠΈΡ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ ΠΈΠ½Π΄Π΅ΠΊΡΠ° ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° (Ρ = 0,033) ΠΈ Π½Π°Π»ΠΈΡΠΈΡ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ (Ρ = 0,002) Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π’ΠΠΠ, Π·Π°Π½ΠΈΠΌΠ°ΡΡΠΈΡ
ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΊΠΎΠΉΠΊΠΈ. ΠΠ°ΠΊ ΡΡΠ΅Π΄ΠΈ ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΡ
, ΡΠ°ΠΊ ΠΈ ΡΡΠ΅Π΄ΠΈ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠ΅ΠΉ Π·Π½Π°ΡΠΈΠΌΠΎ ΡΠ°ΡΠ΅ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΎΡΡ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ ΠΌΡΠΆΡΠΈΠ½Π°ΠΌΠΈ (Ρ = 0,050 ΠΈ Ρ = 0,041 ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ).Π‘ΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΠΌ Π΄Π°Π½Π½ΡΠΌ, ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ 1-ΠΉ ΠΈΠ»ΠΈ 2-ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΠ°ΠΌΠΎΡΡΠΎΡΡΠ΅Π»ΡΠ½ΠΎ (ΠΏΡΠΈ ΠΈΠ·ΠΎΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ ΠΏΡΠΈΡΡΡΡΡΠ²ΠΈΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°) ΡΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ Π½Π΅ ΠΏΠΎΠ²ΡΡΠ°Π»ΠΎ ΡΠ°Π½ΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΌΠ°ΡΡΠΈΠ²Π½ΠΎΠΉ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ. ΠΠ΄Π½Π°ΠΊΠΎ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΠ΅ 3-ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°Π»ΠΎ ΡΠ°Π½ΡΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΌΠ°ΡΡΠΈΠ²Π½ΠΎΠΉ Π’ΠΠΠ Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Π² 2,7 ΡΠ°Π·Π° (ΠΠ¨ = 2,708; ΠΠ: 1,461β5,020)
Π‘ΠΠ₯ΠΠ ΠΠ«Π ΠΠΠΠΠΠ’ Π Π’Π ΠΠΠΠΠΠΠΠΠΠΠ― ΠΠΠΠΠ§ΠΠΠ ΠΠ Π’ΠΠ ΠΠ
Purpose. The aim of the study is to analyze characteristics and the clinical course of pulmonary embolism in patients with diabetes on the basis of the Pulmonary Embolism Register (PE) of deaths inTomskhospitals between 2003 and 2011.Materials and methods. We studied the autopsy reports and medical records of all patients (712 cases) diagnosed with pulmonary embolism anteand/or postmortem, died between 2003 and 2010. Diabetes mellitus was diagnosed in 141 patients and all of them had moderately severe course of the disease or were sub-or decompensated. 28.57% had a high body mass as well: 31,59 + 8,36 kg/m2 . The ratio of medical to surgical patients was 2.1 : 1.Results. All patients with diabetes were hospitalized on an emergency basis. 31 patients (21,6 %) stayed in hospital less than a day, so blood clots β the sources of thromboembolism, were formed at home, outside of hospital. The major source of thromboembolism was inferior vena cava branches. At the same time, 31,4 % diabetic patients had thrombi in the right chambers of the heart. Anticoagulants were used in 16,4 % of cases to prevent thromboembolism.Conclusion. The importance of type 2 diabetes mellitus as a risk factor for thromboembolic complications has been until now underestimated both at the outpatient and hospital stages.Β Π¦Π΅Π»Ρ. ΠΠΎ Π΄Π°Π½Π½ΡΠΌ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π Π΅Π³ΠΈΡΡΡΠ° ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ (Π’ΠΠΠ) ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ Π²Π°ΡΠΈΠ°Π½ΡΡ Π΅Π΅ ΡΠ΅ΡΠ΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΠ·ΡΡΠ΅Π½Ρ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»Ρ Π²ΡΠΊΡΡΡΠΈΠΉ ΠΈ ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (712 ΡΠ»ΡΡΠ°Π΅Π²) Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΏΡΠΈΠΆΠΈΠ·Π½Π΅Π½Π½ΠΎ ΠΈ/ΠΈΠ»ΠΈ ΠΏΠΎΡΠΌΠ΅ΡΡΠ½ΠΎ Π’ΠΠΠ ΡΡΠ΅Π΄ΠΈ ΡΠΌΠ΅ΡΡΠΈΡ
Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
Π’ΠΎΠΌΡΠΊΠ°. Π‘Π°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ Π²ΡΡΠ²Π»Π΅Π½ Ρ 141 Π±ΠΎΠ»ΡΠ½ΠΎΠ³ΠΎ ΠΈ Ρ Π²ΡΠ΅Ρ
ΠΈΠΌΠ΅Π» ΡΡΠ΅Π΄Π½Π΅ΡΡΠΆΠ΅Π»ΠΎΠ΅ ΠΈΠ»ΠΈ ΡΡΠΆΠ΅Π»ΠΎΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅, Π½Π°Ρ
ΠΎΠ΄ΠΈΠ»ΡΡ Π² ΡΡΠ°Π΄ΠΈΠΈ ΡΡΠ±ΠΈΠ»ΠΈ Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΠΈ, Ρ 28,57 % ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π»ΡΡ ΠΏΠΎΠ²ΡΡΠ΅Π½Π½ΠΎΠΉ ΠΌΠ°ΡΡΠΎΠΉ ΡΠ΅Π»Π°. Π‘ΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠ΅ Β«ΡΠ΅ΡΠ°ΠΏΠ΅Π²ΡΠΈΡΠ΅ΡΠΊΠΈΡ
Β» ΠΈ Β«Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
Β» ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 2,2 : 1.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΡΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΡ Ρ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈΡΡ Π² ΡΠΊΡΡΡΠ΅Π½Π½ΠΎΠΌ ΠΏΠΎΡΡΠ΄ΠΊΠ΅; 31 ΠΏΠ°ΡΠΈΠ΅Π½Ρ (21,6 %) Π½Π°Ρ
ΠΎΠ΄ΠΈΠ»ΡΡ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ΅ ΠΌΠ΅Π½Π΅Π΅ ΡΡΡΠΎΠΊ, Ρ. Π΅. ΡΡΠΎΠΌΠ±ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ Π² ΠΌΠ΅ΡΡΠ°Ρ
β ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠ°Ρ
ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Ρ Π½ΠΈΡ
ΠΏΡΠΎΠΈΡΡ
ΠΎΠ΄ΠΈΠ»ΠΎ Π² Π΄ΠΎΠΌΠ°ΡΠ½ΠΈΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
Π²Π½Π΅ ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°. ΠΠ΅Π΄ΡΡΠΈΠΌ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠΎΠΌ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π±ΡΠ»ΠΈ Π²Π΅ΡΠ²ΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ ΠΏΠΎΠ»ΠΎΠΉ Π²Π΅Π½Ρ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ Π²Π΅Π½Ρ ΠΊΡΠ»ΡΡΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ ΠΊΠΎΠ½Π΅ΡΠ½ΠΎΡΡΠΈ. Π 31,4 % ΠΌΠ΅ΡΡΠΎΠΌ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎΠ³ΠΎ ΡΡΠΎΠΌΠ±ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ Π±ΡΠ»ΠΈ ΠΏΡΠ°Π²ΡΠ΅ ΠΊΠ°ΠΌΠ΅ΡΡ ΡΠ΅ΡΠ΄ΡΠ°. ΠΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠΏΡΠΈΡΡΠΈΡ Π² ΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ Π’ΠΠΠ Π² Π²ΠΈΠ΄Π΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π°Π½ΡΠΈΠΊΠΎΠ°Π³ΡΠ»ΡΠ½ΡΠΎΠ² ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈΡΡ Π² 16,4 % ΡΠ»ΡΡΠ°Π΅Π².ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ½Π°ΡΠΈΠΌΠΎΡΡΡ ΡΠ°Ρ
Π°ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π±Π΅ΡΠ° 2-Π³ΠΎ ΡΠΈΠΏΠ° ΠΊΠ°ΠΊ ΡΠ°ΠΊΡΠΎΡΠ° ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ Π΄ΠΎ Π½Π°ΡΡΠΎΡΡΠ΅Π³ΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Π½Π΅Π΄ΠΎΠΎΡΠ΅Π½ΠΈΠ²Π°Π΅ΡΡΡ ΠΊΠ°ΠΊ Π½Π° Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΠΎΠΌ, ΡΠ°ΠΊ ΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΌ ΡΡΠ°ΠΏΠ΅.
ΠΠΠ’ΠΠΠΠΠΠ§ΠΠ‘ΠΠΠ ΠΠΠ Π£Π¨ΠΠΠΠ― Π Π’Π ΠΠΠΠΠΠΠΠΠΠΠ― ΠΠΠΠΠ§ΠΠΠ ΠΠ Π’ΠΠ ΠΠ
The purpose of the study. To examine the contribution of diabetes and obesity in the development of pulmonary embolism on the based data of the Register of new hospital of pulmonary embolism (PE) in hospitals inTomsk(2003β2012). Material and Methods. The medical history and records of autopsies of patients treated in hospitals in the city ofTomsk, 2003β2012, and anatomopathological and/or instrumental examination revealed pulmonary embolism have been subjected to studies. We used the classification of diabetes mellitus proposed by the WHO in1999 inour work, because the register including data (2003β2012). The degree of obesity was assessed according to WHO classification (1997). Statistical analysis of the results was carried out with the help of software for computer Statistica for Windows, version 8.0. The ShapiroβWilk and KolmogorovβSmirnov tests was used to determine the nature of the distribution of the data. The ho mogeneity of the population variance was assessed using Fisher's exact test andLeuventest. The Mannβ Whitney test was used when comparing two independent samples to determine the significance of differences. The analysis was conducted by means of qualitative characteristics contingency tables using Pearson Ο 2 . The odds ratio was calculated to assess the association between a specific outcome and the risk. Data are presented as M Β± SD factor. The significance level of p for all procedures used by the statistical analysis was taken to be 0.05. It was considered statistically significant level of p < 0.05. The results of the study. In intermediate urbanized city ofWestern Siberia,Tomsk, established register of hospital pulmonary embolism (2003β2012). The register included 751patients whose in vivo and / or postmortem revealed pulmonary embolism (PE). The data histories and autopsy reports was analyze. The type 2diabetes was diagnosed in 205 patients. The type 2 diabetes moderate had 29%. Diabetes severe suffer 82 patients (40%). In the group body mass index (BMI) was (29.24 Β± 7.87) kg/m2 . Obesity diagnosed in 157patients (20.9%). It occurs in24.7% of cases for women andin 15.2% of cases for men. If a patient had obesity grade 3 was found to increase the risk of a massive thromboembolism in 3.27 times (OR = 3.27; 95% confidence interval [1.60β6.69]; p = 0.001) and an increase in the risk of fatal thromboembolism 3.56 times(OR = 3.56; 95% CI [1.73β7.43]; p = 0.001). It does not detect the influence of obesity 1 and 2 degrees on the development of a massive pulmonary embolism, or PE, which would cause the patient's death. Significant effect of type 2 diabetes was found on the development of the heavy flow of fatal pulmonary embolism.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ Π΄Π°Π½Π½ΡΡ
Π Π΅Π³ΠΈΡΡΡΠ° Π½ΠΎΠ²ΡΡ
ΡΠ»ΡΡΠ°Π΅Π² Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ (Π’ΠΠΠ) Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
Π³.Β Π’ΠΎΠΌΡΠΊΠ° (2003β2012Β Π³Π³.) ΠΈΠ·ΡΡΠΈΡΡ Π²ΠΊΠ»Π°Π΄ ΡΠ°Ρ
Π°ΡΠ½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π±Π΅ΡΠ° (Π‘Π) ΠΈ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ Π² ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π»Π΅Π³ΠΎΡΠ½ΠΎΠΉ ΡΠΌΠ±ΠΎΠ»ΠΈΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ.Β ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΈ ΠΏΠΎΠ΄Π²Π΅ΡΠ³Π½ΡΡΡ ΠΈΡΡΠΎΡΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»Ρ Π²ΡΠΊΡΡΡΠΈΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ², Π»Π΅ΡΠΈΠ²ΡΠΈΡ
ΡΡ Π² ΡΡΠ°ΡΠΈΠΎΠ½Π°ΡΠ°Ρ
Π³. Π’ΠΎΠΌΡΠΊΠ° Π² 2003β2012Β Π³Π³., Ρ ΠΊΠΎΡΠΎΡΡΡ
ΠΏΡΠΈ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ°Π½Π°Π½ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΒ (ΠΈΠ»ΠΈ) ΠΈΠ½ΡΡΡΡΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π²ΡΡΠ²Π»Π΅Π½Π° Π’ΠΠΠ. Π£ΡΠΈΡΡΠ²Π°Ρ ΡΡΠΎΠΊΠΈ ΡΠΎΠ·Π΄Π°Π½ΠΈΡ Π Π΅Π³ΠΈΡΡΡΠ° (2003β2012Β Π³Π³.), Π² Π½Π°ΡΠ΅ΠΉ ΡΠ°Π±ΠΎΡΠ΅ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»Π°ΡΡ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ Π‘Π, ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½Π½Π°Ρ ΠΠΠ Π² 1999Β Π³. Ρ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΡΡΠΈΠΌΠΈ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌΠΈ. Π‘ΡΠ΅ΠΏΠ΅Π½Ρ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΠΠ (1997).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅.Β Π ΡΡΠ΅Π΄Π½Π΅ΡΡΠ±Π°Π½ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΌ Π³ΠΎΡΠΎΠ΄Π΅ ΠΠ°ΠΏΠ°Π΄Π½ΠΎΠΉ Π‘ΠΈΠ±ΠΈΡΠΈ β Π’ΠΎΠΌΡΠΊΠ΅ β ΡΠΎΠ·Π΄Π°Π½ Π Π΅Π³ΠΈΡΡΡ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½ΠΎΠΉ Π’ΠΠΠ (2003β2012Β Π³Π³.). Π Π Π΅Π³ΠΈΡΡΡ Π±ΡΠ» Π²ΠΊΠ»ΡΡΠ΅Π½ 751 ΠΏΠ°ΡΠΈΠ΅Π½Ρ, Ρ ΠΊΠΎΡΠΎΡΠΎΠ³ΠΎ ΠΏΡΠΈΠΆΠΈΠ·Π½Π΅Π½Π½ΠΎ ΠΈΒ (ΠΈΠ»ΠΈ) ΠΏΠΎΡΠΌΠ΅ΡΡΠ½ΠΎ Π²ΡΡΠ²Π»Π΅Π½Π° Π’ΠΠΠ. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΈΡΡΠΎΡΠΈΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»ΠΎΠ² ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
Π²ΡΠΊΡΡΡΠΈΠΉ. Π‘Π°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ 2-Π³ΠΎ ΡΠΈΠΏΠ° (Π‘Π-2) Π²ΡΡΠ²Π»Π΅Π½ Ρ 205 Π±ΠΎΠ»ΡΠ½ΡΡ
, ΠΈΠ· Π½ΠΈΡ
60 (29%) ΠΈΠΌΠ΅Π»ΠΈ Π‘Π-2 ΡΡΠ΅Π΄Π½Π΅ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ. ΠΠΈΠ°Π±Π΅ΡΠΎΠΌ ΡΡΠΆΠ΅Π»ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΡΠ°Π΄Π°Π»ΠΈ 82 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ° (40%). ΠΠ½Π΄Π΅ΠΊΡ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° (ΠΠΠ’) Π² Π³ΡΡΠΏΠΏΠ΅ Π»ΠΈΡ, ΡΡΡΠ°Π΄Π°ΡΡΠΈΡ
Π‘Π, ΡΠΎΡΡΠ°Π²ΠΈΠ» (29,24Β Β±Β 7,87)Β ΠΊΠ³/ΠΌ2. ΠΠΆΠΈΡΠ΅Π½ΠΈΠ΅ Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½ΠΎ Ρ 157 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² (20,9%). Π£ ΠΆΠ΅Π½ΡΠΈΠ½ ΠΎΠ½ΠΎ Π²ΡΡΡΠ΅ΡΠ°Π»ΠΎΡΡ Π² 24,7% ΡΠ»ΡΡΠ°Π΅Π², Ρ ΠΌΡΠΆΡΠΈΠ½ β Π² 15,2%. ΠΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ 3-ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΌΠ°ΡΡΠΈΠ²Π½ΠΎΠΉ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π² 3,27 ΡΠ°Π·Π° (ΠΠ¨Β =Β 3,27; 95%-ΠΉ ΠΠ [1,60β6,69];Β ΡΒ =Β 0,001) ΠΈ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΡΠΎΠΌΠ±ΠΎΡΠΌΠ±ΠΎΠ»ΠΈΠΈ Π² 3,56 ΡΠ°Π·Π° (ΠΠ¨Β =Β 3,56; 95%-ΠΉ ΠΠ [1,73β7,43];Β pΒ =Β 0,001). ΠΡΠΈ ΡΡΠΎΠΌ Π½Π΅ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ ΠΎΠΆΠΈΡΠ΅Π½ΠΈΡ 1-ΠΉ ΠΈ 2-ΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ Π½Π° ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ ΠΌΠ°ΡΡΠΈΠ²Π½ΠΎΠΉ Π’ΠΠΠ, ΠΈΠ»ΠΈ Π’ΠΠΠ, ΠΊΠΎΡΠΎΡΠ°Ρ ΡΡΠ°Π»Π° Π±Ρ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ ΡΠΌΠ΅ΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°. ΠΡΡΠ²Π»Π΅Π½ΠΎ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ΅ (Ρ £ 0,001) Π²Π»ΠΈΡΠ½ΠΈΠ΅ Π‘Π-2 ΡΡΠΆΠ΅Π»ΠΎΠ³ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π½Π° Π»Π΅ΡΠ°Π»ΡΠ½ΡΠΉ ΠΈΡΡ
ΠΎΠ΄ Π’ΠΠΠ