СОВРЕМЕННЫЕ ВОЗМОЖНОСТИ МЕДИКАМЕНТОЗНОЙ КОРРЕКЦИИ ЭНДОТЕЛИАЛЬНОЙ ДИСФУНКЦИИ У ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА В ИНТРАОПЕРАЦИОННОМ И РАННЕМ ПОСЛЕОПЕРАЦИОННОМ ПЕРИОДЕ ПОСЛЕ РЕВАСКУЛЯРИЗАЦИИ МИОКАРДА
Аннотация
Введение. Эндотелиальная дисфункция – одно из основных патогенетических звеньев атеросклеротического поражения артериального сосудистого русла, результатом прогрессирования которого является развитие ишемической болезни сердца и ее осложнений.
Цель. На основании литературных данных изучить влияние основных групп лекарственных средств для лечения ишемической болезни сердца на функцию эндотелия и системную гемодинамику у кардиохирургических пациентов после проведения реваскуляризации миокарда.
Материал и методы. Представлен обзор и анализ литературных данных источников.
Результаты. Ингибиторы рецепторов ангиотензин-превращающего фермента, сенситизаторы кальция, ингибиторы фосфодиэстеразы III типа, бета-блокаторы в основном позитивно влияют на функцию эндотелия. Нитраты оказывают отрицательное воздействие в условиях критического кровообращения на его функцию и должны с осторожностью использоваться при эндотелиальной дисфункции.
Выводы. Полученные данные свидетельствуют о влиянии ингибиторов рецепторов ангиотензин-превращающего фермента, сенситизаторов кальция, ингибиторов фосфодиэстеразы III типа и бета-блокаторов на функцию эндотелия. Однако указанные группы лекарственных средств могут негативно влиять на системную гемодинамику в периоперационном периоде, что требует обдуманного подхода к их назначению.
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