Введение. Транспортировка биоматериала для лабораторных исследований системы гемостаза посредством пневмопочты, по данным литературы, может оказать влияние на результаты, в частности, вследствие механического воздействия на клетки крови. Цель исследования: провести валидацию показателей тромбоцитарного и плазменного звеньев гемостаза при доставке биоматериала в лабораторию пневмопочтой и традиционным «ручным» способом у пациентов, получающих антитромботическую терапию. Материалы и методы. В исследование были включены 52 образца венозной крови, взятой в дублях, от 30 пациентов, идущих на оперативное вмешательство. Всем пациентам до операции назначалась нагрузочная доза антиагрегантов: ацетилсалициловая кислота 100 мг и клопидогрел 300 мг. Венозную кровь отбирали в 2 пробирки, одну доставляли в лабораторию пневмопочтой, вторую приносила медицинская сестра. В каждой пробирке определяли агрегационную активность тромбоцитов турбидиметрическим методом с использованием индукторов — АДФ (10 мкг/мл и 2,5 мкг/мл) и коллагена (20 мг/мл), а также протромбиновое время по Квику, международное нормализованное отношение (МНО), активированное частичное тромбопластиновое время (АЧТВ), тромбиновое время, содержание фибриногена и D-димера. Результаты. Применение статистических критериев сравнения по различным вариантам доставки биоматериала не выявило значимых различий ни по одному из показателей (р > 0,05). Сопоставление разницы, выраженной в процентах, с коэффициентом аналитической вариации показало, что для всех показателей различия при транспортировке пневмопочтой и вручную не превышают коэффициента аналитической вариации. Наименьшим было различие в тесте АЧТВ — 0,2% в сторону удлинения при доставке пневмопочтой. Для МНО различия в зависимости от способа доставки отсутствовали. Заключение. Транспортировка крови для оценки коагуляционных тестов и агрегационной активности тромбоцитов турбидиметрическим методом может осуществляться в капсулах пневмопочты без потерь в качестве и не влечет за собой нарушений преаналитического этапа. Introduction. According to the literature, transporting biomaterial for hemostasis lab tests by the pneumatic tube system may affect the results, particularly, due to mechanical effect on the blood cells. Objective: to validate platelet and plasma hemostasis parameters in patients receiving antithrombotic therapy during the biomaterial delivery to the laboratory either by pneumatic tubesor by the traditional “manual” method. Materials and Methods. The study included 52 pairs of samples of thevenous blood withdrawn from 30 patients scheduled for the surgery. A loading dose of antiplatelet agents was prescribed to all patients before the surgery: acetylsalicylic acid 100 mg and clopidogrel 300 mg. Venous blood was collected in 2 test tubes: the first one was delivered to the laboratory by the pneumatic tube, the second one — by the nurse. Platelet aggregation activity was determined in each tube by turbidimetric method using inducers — ADP (10 μg/mL and 2.5 μg/mL) and collagen (20 mg/mL). Quick’s prothrombin time, international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen, thrombin time, and D-dimer were also measured. Results. The use of statistical comparison criteria for various options of the biomaterial delivery did not reveal significant differences in any of the parameters (p > 0.05). Comparison of the difference (expressed as the percentage) with the coefficient of analytical variation showed that for all parameters, differences during transportation by pneumatic tubes and “manually” did not exceed the coefficient of analytical variation. The smallest difference was observed in the APTT test — 0.2% elongation during delivery by pneumatic tube system. For INR, there were no differences depending on the delivery method. Conclusion. Blood transportation for assessing coagulation tests and platelet aggregation activity (by turbidimetric method) can be carried out in capsules of pneumatic tube system without loss in quality and any negative impact on the preanalytical stage.

Poyavivshayasya v dekabre 2019 g. novaya koronavirusnaya infekciya, vyzvannaya virusom SARS-CoV-2, pochti za god unesla zhizni 2,5 mln chelovek. Vysokaya kontagioznost' virusa privela k ego shirokomu i bystromu rasprostraneniyu po vsemu miru. Po sostoyaniyu na fevral' 2021 g. obshchee chislo zabolevshih dostigaet 111 mln chelovek; v RF zaregistrirovano bolee 4 mln sluchaev zarazheniya SARS-CoV-2. Dlya uspeshnoj bor'by s voznikshej pandemiej neobhodimo bystro diagnostirovat' zabolevanie na rannej stadii, chto pozvolit predotvrashchat' dal'nejshee rasprostranenie etogo virusa i svoevremenno naznachat' neobhodimoe lechenie. Cel'yu raboty bylo ocenit' ispol'zovanie nukleokapsidnogo antigena (N-Ag) SARS-CoV-2 i sootvetstvuyushchih antitel v kachestve diagnosticheskih markerov u bol'nyh pnevmoniej. Issledovanie provodili v razgar pandemii COVID-19 v Moskve (Rossiya). V nego voshli 425 ekstrennyh pacientov s klinicheskimi priznakami pnevmonii COVID-19, iz kotoryh 280 (66%) byli polozhitel'ny libo na syvorotochnyj N-Ag, libo na sootvetstvuyushchie emu antitela. Prodemonstrirovana obshchaya rasprostranennost' serokonversii N-Ag u pacientov s pnevmoniej, associirovannoj s SARS-CoV-2, v techenie 3–5 dnej posle gospitalizacii. Poluchennye rezul'taty svidetel'stvuyut o vysokoj celesoobraznosti serodiagnostiki SARS-CoV-2 u ekstrennyh bol'nyh.

The fact that microRNAs play an important role in the development and pathogenesis of cardiovascular disease is beyond doubt. This article provides a brief overview of recent data that relate to microRNA expression in various cardiovascular diseases. Detecting significant changes in the level of expression of these molecules in various diseases means that microRNAs can be considered to be potential biomarkers of human pathologies including heart failure. Studying the relationship between the mechanisms of cardiovascular disease and the level of expression of a variety of microRNAs, as well as establishing their exact relationships with the genes is an urgent problem and requires further research.

The study was carried out to determine the prognostic value of alpha-fetoprotein in development of lethal outcome and degree of functional rehabilitation of patients with ischemic stroke. The sampling included 216 patients in acute period of ischemic stroke. At the first day of development of disease they were measured the level of human alpha-fetoprotein. At the second day of disease patients were evaluated the degree of functional rehabilitation and the rate of lethal outcomes was calculated. Previously, the reference interval for alpha-fetoprotein was calculated according the guidelines of the International federation of clinical chemistry and national standard. The reference interval amounted to 0.59-3.78 mE/l. The study results demonstrated that low level of alpha-fetoprotein is related to higher risk of lethal outcome (SE=1.7, p=0.012). The increasing of level of alpha-fetoprotein over mentioned threshold value statistically significant increases probability of survival of patients. The further increasing more than 2.28 mE/l is related to subsequent good functional rehabilitation according the modifies Rankine scale (SE=1.4, p=0.001) and Barthel index (SE=1.49, p<0.001).

The searching of laboratory predictors of pneumonia in patients with ischemic stroke is an actual issue. The fetal proteins can be such biomarkers. The study was carried out to determine significance of such fetal proteins as alpha-fetoprotein, cancerous embryonic antigen, CA 19-9, CA 125, CA 15-3, CA 72-4, CYFRA 21-1 for prognosis of development of pneumonia in patients with ischemic stroke. The study included sampling of 216 patients in acute period of ischemic stroke. All patients were measured level of fetal proteins in first day from onset of disease using electrochemiluminescence immunoassay. It is demonstrated that CA 72-4 has the most significance for prognosis of development of pneumonia from all analyzed proteins and complications of ischemic stroke. The probability ratio relatively to other fetal proteins added up to 0.460 (CL 95% 0.267-0.791, p=0.011), to other complications--0.629 (CL 95% 0.433-0.913, p=0.015). The threshold value of CA 72-4 for development of pneumonia added up to 0.82 (CL 95% 0.68-0.96, p=0.011) U/ml. Under lower level of CA 72-4 the risk of development of pneumonia increases. Under higher level of CA 72-4 there is statistical probability of absence of developmnent of pneumonia. The threshold value was lower than reference interval which in the study added up to 0.85-1.42 U/ml. The detection of level of CA 72-4 on first day after onset of stroke in patients can be recommended for establishing of group of high risk of development of pneumonia and implementation of therapeutic activities.

The markers of regulation vascular tone, such as rennin, endothelin-1, and C-type natriuretic peptide, are of great value for prognosis of hemorrhagic transformation and fatal outcome of ischemic stroke. A change in the vascular tone in case of hemorrhagic transformation at the affected site precedes activation of the coagulation component of hemostasis as a mechanism preventing blood loss and increasing fibrinogen level. This work was aimed to study the balance of the above markers and fibrinogen in the prognosis of hemorrhagic transformation and fatal outcome in the acute period of ischemic stroke. It included 62 patients receiving no thrombolytic therapy. It was shown that symptomatic hemorrhagic transformation was associated with elevated rennin levels without a marked fall in the level of C-type natriuretic peptide and asymptomatic hemorrhagic transformation with elevated endothelin-1 levels and decreased concentration of natriuretic peptide. Fibrinogen level on day 4 of the observation proved to be a reliable predictor of negative prognosis. Asymptomatic hemorrhagic transformation without fatal outcome was associated with systemic and local vasoconstriction and inhibition of local vasodilation. Symptomatic hemorrhagic transformation with the fatal outcome was accompanied by dysregulation of vascular tone in the form of activation of systemic and local vasoconstriction, insufficient inhibition of local vasodilation and compensatory reaction in the form of activation of hemostatic mechanisms manifest as elevated fibrinogen levels on day 4. The lethal outcome without hemorrhagic transformation was associated with systemic vasoconstriction, activation of local vasodilation and vasoconstriction leading to local "biochemical paralysis" of vascular tone regulation.