vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2026-23-3-214-222vestim-1103Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEОсобенности механизмов транспорта кислорода крови в зависимости от стадий первичной открытоугольной глаукомыBlood oxygen transport mechanisms at different stages of primary open-angle glaucomahttps://orcid.org/0009-0008-3066-9916РоманчукВ. В.RomanchukV. V.

Романчук Вита Вальдемаровна – ст. преподаватель 

ул. Горького, 80, 230009, г. Гродно 

Vita V. Romanchuk – Senior Lecturer 

80, Gorky Str., 230009, Grodno 

vita8w8@mail.ruhttps://orcid.org/0000-0002-3077-0474ЗинчукВ. В.ZinchukV. V.

Зинчук Виктор Владимирович – д-р мед. наук, профессор, заведующий кафедрой

ул. Горького, 80, 230009, г. Гродно

Viktor V. Zinchuk – D. Sc. (Med.), Professor, Head of the Department

80, Gorky Str., 230009, Grodno 

zinchuk@grsmu.byhttps://orcid.org/0000-0002-5852-2616КрасильниковаВ. Л.KrasilnikovaV. L.

Красильникова Виктория Леонидовна – д-р мед. наук, профессор. Институт повышения квалификации и переподготовки кадров здравоохранения

ул. П. Бровки, 3/3, 220013, г. Минск

Victoria L. Krasilnikova – D. Sc. (Med.), Professor. Institute for Advanced Training and Retraining of Healthcare Personnel

3/3, P. Brovki Str., 220013, Minsk 

krasilnikova_vik@mail.ruГродненский государственный медицинский университетБеларусьGrodno State Me­dical UniversityBelarusБелорусский государственный медицинский университетБеларусьBelarusian State Medical UniversityBelarus202630082026233214222Copyright © Романчук В.В., Зинчук В.В., Красильникова В.Л., 20262026Романчук В.В., Зинчук В.В., Красильникова В.Л.Romanchuk V.V., Zinchuk V.V., Krasilnikova V.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/1103

Глаукома является одной из ведущих причин необратимой слепоты во всем мире.Цель исследования – оценить особенности механизмов транспорта кислорода крови в зависимости от стадий первичной открытоугольной глаукомы (ПОУГ).Общее число участников исследования составило 130 человек, из них 100 пациентов – с диагнозом ПОУГ I–IV стадии и 30 лиц – без глаукомы. Для оценки толщины хориоидеи использована оптическая когерентная томография. В венозной крови осуществлялось определение содержания газотрансмиттеров – монооксида азота (NO) и сероводорода (H2S). Устанавливались показатели кислородтранспортной функции крови.С прогрессированием ПОУГ выявлено стойкое уменьшение толщины хориоидеи, обнаружен дисбаланс уровня газотрансмиттеров (увеличение концентрации NO и уменьшение H2S), увеличение сродства гемоглобина к кислороду и смещение кривой диссоциации оксигемоглобина влево. Истончение хориоидеи составило: на II стадии – 10,8 % (p = 0,001), а на III–IV стадиях – 31,0 % (p < 0,001) по сравнению с контрольной группой. Наблюдалось увеличение концентрации NO с прогрессированием заболевания: на I стадии – 30,2 % (p = 0,002), на II стадии – 38,6 % (p < 0,001), на III–IV стадиях – 108,9 % (p < 0,001) по сравнению с контролем. Концентрация H2S была снижена на 21,9 % (p = 0,034) на II стадии и на 54,1 % (p < 0,001) – на III–IV стадиях по сравнению с лицами, не страдающими данным заболеванием. Наибольшее снижение р50реал и р50станд, отражающее увеличение сродства гемоглобина к кислороду, наблюдалось на II стадии – на 10,1 % (p = 0,009) и 10,0 % (р < 0,001) соответственно.Результаты исследования демонстрируют сложный и многокомпонентный механизм развития глаукомы, который сопровождается определенными структурно-функциональными изменениями механизмов транспорта кислорода крови.

Glaucoma is one of the leading causes of irreversible blindness worldwide.The aim of the study was to evaluate blood oxygen transport mechanisms at different stages of primary open-angle glaucoma (POAG).The total number of study participants was 130, including 100 patients diagnosed with POAG stages I–IV and 30 indi­ viduals without glaucoma. Optical coherence tomography was used to assess choroidal thickness. Gasotransmitters (nitric oxide (NO) and hydrogen sulfide (H2S)) and blood oxygen transport parameters were analyzed in venous blood.Progressive POAG was associated with a persistent decrease in choroidal thickness, an imbalance in gasotransmitter levels (increased nitric oxide and decreased hydrogen sulfide concentrations), increased hemoglobin affinity for oxygen, and a leftward shift of the oxyhemoglobin dissociation curve. Choroidal thinning was 10.8 % at stage II (p = 0.001) and 31.0 % at stages III–IV (p < 0.001) compared to the control group. Nitric oxide concentration increased with disease progression: by 30.2 % at stage I (p = 0.002), 38.6 % at stage II (p < 0.001), and 108.9 % at stages III–IV (p < 0.001) relative to controls. Hydrogen sulfide levels decreased: by 21.9 % at stage II (p = 0.034) and by 54.1 % at stages III–IV (p < 0.001) compared with individuals without the disease. The greatest reduction in real and standard p50, reflecting increased hemoglobin affinity for oxygen, was observed at stage II – by 10.1 % (p = 0.009) and 10.0 % (p < 0.001), respectively.The study results demonstrate the complex and multifactorial pathogenesis of glaucoma, which is accompanied by specific structural and functional changes in blood oxygen transport mechanisms.

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The authors declare that there are no conflicts of interest present.