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"10.29235/1814-6023-2020-17-4-470-479vestim-716Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEКоррекция метаболических нарушений у пациентов с аневризматическими внутричерепными кровоизлияниямиCorrection of metabolic disorders in patients with aneurysmal intracranial hemorrhagesНечипуренкоН. И.NechipurenkoN. I.

Нечипуренко Наталия Ивановна – доктор медицинских наук, профессор, заведующий лабораторией

ул. Ф. Скорины, 24, 220114, г. Минск

 

Natalia I. Nechipurenko – D. Sc. (Med.), Professor, Head of the Laboratory

24, F. Skorina Str., 220114, Minsk

prof_NIN@mail.ruСидоровичР. Р.SidorovichR. R.

Сидорович Рышард Ромуальдович – доктор медицинских наук, доцент, директор

ул. Ф. Скорины, 24, 220114, г. Минск

 

Ryszard R. Sidorovich – D. Sc. (Med.), Assistant Professor, Director

24, F. Skorina Str., 220114, Minsk

ninh@mail.ruПашковскаяИ. Д.PashkouskayaI. D.

Пашковская Ирина Дмитриевна – кандидат биологических наук, ведущий научный сотрудник

ул. Ф. Скорины, 24, 220114, г. Минск

 

Irina D. Pashkovskaya – Ph. D. (Biol.), Leading Researcher

24, F. Skorina Str., 220114, Minsk

irenapass@mail.ruАхремчукА. И.AhremchukA. I.

Ахремчук Антон Игоревич – врач-нейрохирург

ул. Ф. Скорины, 24, 220114, г. Минск

 

Anton I. Ahremchuk – Neurosurgeon

24, F. Skorina Str., 220114, Minsk

ahremen@mail.ruПрокопенкоТ. А.ProkopenkoT. A.

Прокопенко Татьяна Анатольевна – младший научный сотрудник

ул. Ф. Скорины, 24, 220114, г. Минск

Tatiana A. Prokopenko – Junior Researcher

24, F. Skorina Str., 220114, Minsk

Республиканский научно-практический центр неврологии и нейрохирургииRepublican Research and Clinical Center of Neurology and Neurosurgery202005122020174470479Copyright © Нечипуренко Н.И., Сидорович Р.Р., Пашковская И.Д., Ахремчук А.И., Прокопенко Т.А., 20202020Нечипуренко Н.И., Сидорович Р.Р., Пашковская И.Д., Ахремчук А.И., Прокопенко Т.А.Nechipurenko N.I., Sidorovich R.R., Pashkouskaya I.D., Ahremchuk A.I., Prokopenko T.A.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/716

В статье оценены тяжесть клинического состояния и ряд биохимических показателей 51 пациента с аневризматическим внутричерепным кровоизлиянием (ВЧК) на момент госпитализации и после проведения нейрохирургического лечения, включавшего наряду со стандартной терапией использование сульфата магния. Так, на момент госпитализации у 75 % пациентов контрольной группы и у 50 % основной установлен церебральный сосудистый спазм по данным транскраниальной допплерографии, выявлены активация процессов перекисного окисления липидов, снижение активности супероксиддисмутазы, увеличение содержания фактора роста эндотелия сосудов и высокочувствительного С-реактивного белка (СРБ) при уменьшении уровня стабильных продуктов обмена монооксида азота. У пациентов основной группы после нейрохирургического лечения и курсового применения сульфата магния отмечалось статистически значимое улучшение клинического состояния по шкале Ханта–Хесса и модифицированной шкале Фишера, а также увеличение баллов по шкале комы Глазго при нормализации показателей про-, антиоксидантного состояния крови. В то же время у пациентов обеих групп сохранялись высокое содержание высокочувствительного СРБ и низкий уровень нитратов/нитритов в крови. Следовательно, использование сульфата магния в дополнение к стандартной терапии способствует улучшению клинического состояния пациентов с ВЧК и повышению антиоксидантного потенциала крови в послеоперационном периоде.

The article presents data assessment of the severity of the clinical condition and a number of biochemical parameters in 51 patients with aneurysmal intracranial hemorrhage on the 10th day, on average, after the rupture of the arterial aneurysm and after treatment with the additional use of magnesium sulfate to standard therapy in the postoperative period. It is shown, that at the time of hospitalization, 75 % of patients in the control group and 50 % of patients in the main group had cerebral vascular spasm according to transcranial dopplerography; activation of lipid peroxidation processes, a decrease in superoxide dismutase activity, an increase in the content of vascular endothelial growth factor and highly sensitive C-reactive protein (CRP) with a decrease in the level of stable nitrogen monoxide exchange products were detected. A statistically significant improvement in the clinical condition of patients on the Hunt-Hess scale, the modified Fisher scale, and an increase in the score on the Glasgow coma scale with normalization of pro- and antioxidant status of the blood were revealed in the main group after neurosurgical treatment and course use of magnesium sulfate. At the same time, high levels of highly sensitive CRP and low levels of nitrates/nitrites in the patients blood of both groups are maintained. Consequently, the additional use of magnesium sulfate improves the clinical condition of patients with intracranial hemorrhage and increases the antioxidant potential of the blood in the postoperative period.

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