INDICATIVE ESTIMATION OF TISSUE HYPOXIA IN YOUNG PATIENTS WITH SPONDYLOGENIC VERTEBRO- BASILAR INSUFFICIENCY

Nekrasova N.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Vertebrobasilar system contains structures that are crucial for keeping a person alive, therefore study of the blood dyscirculation in this area in relation to autonomic provision is an important part of practical neurology. One of the magistral arteries of the neck (vertebral artery) goes through transverse foramina to the cranial cavity and nourishes the: сerebellum (involved in motor control beside the balance), vestibular apparatus (equilibriumrelated function), limbic system (supports a variety of functions including artery and vein tone, emotion, short-term memory and viscera functions) and other vital centers located in the brainstem. Vertebrobasilar insufficiency (VBI) is a broad classification describing the condition where there is an insufficient delivery of blood flow via the vertebral and/or basilar arteries to the brain. In young patients (less than 45 years) more prominent is spondylogenic mechanism of VBI, so such called spondylogenic vertebrobasilar insufficiency represents a big deal interest. To understand and be ready to diagnose vertebrobasilar ischemia at the early stages we can’t underestimate the meaning of biochemical changes which are present in the organism of patients. Research objective: to study the state of 2,3 – diphosphogliceratis of erythrocytes at the different stages of spondylogenic VBI in young patients. Object and methods. We examined 240 patients with manifestations of SVBI on the background of neurovascular and radicular syndromes of cervical osteochondrosis of a vertebral column. Patients from 18 to 44 years (median age of 28.5±3.8 years) were included in this study. All patients underwent an ultrasonic dopplerography and transcranial dopplerography of cerebral vessels with functional loading tests (head rotations), with the aim of assessing spondylogenic influence on vertebral arteries, functional X-ray examination of the neck, MRI cervical part of vertebral column, duplex scanning of neck vessels. As basic index of turbulent blood flow influence on the endothelium (ISD) was calculated. ISD=VS/VD, де VS – systolic blood flow in VA, VD – diastolic blood flow in VA. The concentration of 2,3 – diphosphogliceratis of erythrocytes in the blood by spectrophotometric method was checked. groups of patients were formed: Group 1 consisted of 104 patients with an angiodystonic stage of VBI; Group 2 consisted of 76 patients with an angiodystonic-ischemic stage of VBI; Group 3 consisted of 60 patients with an ischemic stage of VBI. As a result of examination of 240 patients with verified diagnosis vertebro-basilar insufficiency of spondylogenic origin, the main regularities of systole-diastolic ratio changes were concluded. The content of 2,3-diphosphogliceratis of erytrocytes at different stages of VBI comparing with the control group was studied. Obtained data makes possible to expand the understanding of the pathogenetic mechanisms of the development of VBI on the background of spondylogenic disorders. The generalization of the revealed regularities allows to make a conclusion about the clinical informativity of systole-diastolic ratio and dependence of 2,3-diphosphogliceratis of erythrocytes from this ration. The necessity of studying these indexes at the different stages of development of VBI is very important for further usage in the system of clinical and instrumental diagnostics of early manifestations in young patients.

tissue hypoxia, spondylogenic vertebro-basilar insufficiency

• Bayshukurova A.K. Obrazovaniye 2,3-DFG v eritrotsitakh pri eksperimentalnykh vozdeystviyakh, izmenyayushchikh usloviya transporta kisloroda: avtoref. dis. ...kand. biol. Nauk / A.K. Bayshukurova. – Leningrad, 1966. – 20 s.
• Grishchenko V.I. Zagotovka i kriokonservirovaniye eritrotsitov platsentarnoy krovi dlya transfuzy / V.I. Grishchenko, O.S. Prokopyuk, M.I. Shrago // Problemy kriobiologii. – 1989. – № 2. – S. 31-33.
• Zozulya І.S. Tranzitornі ishemichni ataki u vertebro-bazilyarnіy sistemі zumovlenі patologіеyu shynogo vіddіlu khrebta / І.S. Zozulya, V.G. Nesukay // Lіki Ukraуni. – 2013. – № 3. – S. 4-9.
• Kalashnikov V.I. Sindrom pozvonochnoy arterii / V.I. Kalashnikov // Therapia. – 2007. – № 10. – S. 31-33.
• Kamchatnov P.R. Vertebralno-bazilyarnaya nedostatochnost – problemy diagnostiki i terapii / P.R. Kamchatnov, A.V. Chugunov, N.A. Mikhaylova // Meditsinsky sovet. – 2013. – № 1. – S. 69-73.
• Kandyba D.V. Spondilogenny sindrom pozvonochnoy arterii: posobiye dlya vrachey / D.V. Kandyba. – SPb.: SPbMAPO, 2009. – 64 s.
• Klinicheskaya laboratornaya diagnostika. Natsionalnoye rukovodstvo. – M.: GEOTAR-Media, 2012. – T. 1. – 928 s.
• Kovalenko O.Ye. Fenotipicheskaya kharakteristika bolnykh s tservikovertebrogennymi vertebralno-bazilyarnymi narusheniyami / O.Ye. Kovalenko, L.P. Sheyko // Sb. nauchnykh rabot sotrudnikov KMAPO im. P.L. Shupika. – K., 2005. – Vip. 14, kn. 1. – S. 39-46.
• Kukes V.G. Vliyaniye antioksidantov na napryazheniye kisloroda v krovi u patsiyentov s khronicheskoy serdechnoy nedostatochnostyu / V.G. Kukes, A.B. Prokofyev, O.A. Checha, O.A. Goroshko, I.A. Mazerkina, Ye.Yu. Demchenkova // Mezhdunarodny zhurnal prikladnykh i fundamentalnykh issledovany. – 2016. – № 6-1. – S. 56-58.
• Melkumyants A.M. Mekhanochuvstvitelnost arterialnogo endoteliya / A.M. Melkumyants, S.A. Balashov. – M.: Triada, 2005. – 205 s.
• Nekrasova N.A. Izucheniye nekotorykh pokazateley metabolizma u patsiyentov molodogo vozrasta so spondilogennoy vertebralnobazilyarnoy nedostatochnostyu / N.A. Nekrasova // Zhurnal Grodnenskogo Gosudarstvennogo meditsinskogo universiteta. – 2015. – № 2 (50). – S. 73-75.
• Paеnok A.V. Vertebrobazilyarna nedostatnіst mozkovogo krovoobіgu іі zv’yazok iz patologіchnimi zmіnami u shynomu vіddіlі khrebta / A.V. Paеnok, O.M. Kozar-Gursha // Bukovinsky medichny vіsnik. – 2012. – T. 16, № 3 (63). – S. 67-70.
• Sitel A.B. Vliyaniye degenerativno-distroficheskikh protsessov v sheynom otdele pozvonochnika na narusheniya gemodinamiki v vertebralno-bazilyarnoy sisteme / A.B. Sitel, K.O. Kuzminov, M.A. Bakhtadze // Manualnaya terapiya. – 2010. – № 1 (37). – S. 10-21.

«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 173-176 pages, index UDK 616.31:[616.831-008.6-02:616.134.9/.93-018.74-008.1]-07

10.29254/2077–4214–2017–4–3–141–173-176