Objective: to study the effect of reproductive hormones on the blood lipoprotein spectrum in the postresuscitation period after cardiac arrest. Materials and methods. Experiments were carried out on 66 mature albino rats of either sex weighing 200—250 g. Ten-minute cardiac arrest was induced by intrathoracic ligation of the vascular bundle. At 30 min after resuscitation, 49 animals were intramuscularly injected placebo and 17 animals were administered gyn-odian depot (Schering, Germany). The investigators measured the plasma concentrations of progesterone, 17-OH progesterone, androstenedione, dehydroepiandrosterone sulfate, testosterone, estradiol, and estriol, as well as the levels of triglycerides, total, and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) cholesterols. Blood was sampled on days 2 and 16 in the absence of therapy and on day 16 of sex steroid therapy. Results. By day 2 postresuscitation, the progesterone/estradiol ratio increased by approximately 1.8 times in males and females. Despite the fact that there were no changes in the concentrations of triglycerides, VLDL and HDL cholesterols in both males and females at that time, but the level of LDL cholesterol increased. Gender-related differences in the LDL spectrum by day 2 postresuscitation remained only in the levels of LDL cholesterol. Despite the normalization of progesterone levels, the concentrations of triglycerides and VLDL cholesterol decreased by day 16 of the postresuscitative period in the absence of therapy. There were no gender-related differences in the lipoprotein spectrum at this stage. The exogenous estradiol in combination with dehydroepiandrosterone caused a significant increase in the concentration of HLD cholesterol and a reduction in that of VLDL cholesterol in males and females both. Conclusion. Under gynodian action, the lipid spectrum was indicative of the exogenous estra-diol and dehydroepiandrosterone sulfate activation of the receptor transport of polyunsaturated fatty acids to the cells and that of reverse cholesterol outflow from the cell membranes in the resuscitated animals. Key words: cardiac arrest, reproductive steroids, blood lipoproteins, gynodian, postresuscitation period.

Objective: to study whether reamberin and hydroxyethyl starch may be used to correct dyslipoproteinemia in gestosis. Subjects and methods: Twenty-two patients with early postoperative gestosis were examined. Group 1 patients (n=8) received the standard treatment. In addition to the standard treatment, Group 2 patients (n=7) were given 6% hydroxyethyl starch solution infusion at concentrations of 5-6 ml/kg body weight at a rate of 3 ml/ml. Just after hydroxyethyl starch infusion, Group 3 patients (n=7) were additionally injected 1.5% reamberin by the above scheme. The results of examinations were compared with the data obtained on examination of 8 puerperas after pregnancy and normal delivery (Group 4). The plasma concentration of triglycerides, total cholesterol (TC), and the cholesterols of high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) were measured. Results and discussion. All the puerperas with gestosis were found to have hypertriglyceridemia and elevated levels of VLDL cholesterol with decreased concentrations of HDL cholesterol. The moderately higher levels of triglycerides and TC were also observed in patients without gestosis. Hydroxyethyl starch lowered the concentration of triglycerides by postpartum days 3—4. When hydroxyethyl starch was used in combination with reamberin, there was a significant reduction in the concentrations of triglycerides and VLDL and LDL cholesterols and a substantial rise in the level of HDL cholesterol. By postpartum days 3 and 4, Group 1 showed a considerable increase in the atherogenicity coefficient, which was significant as compared with the baseline level. Hydroxyethyl starch alone prevented an increase in the atherogenici-ty coefficient while its use in combination with reamberin significantly lowered this index and normalized it by postpartum days 3—4. Conclusion. Hydroxyethyl starch alone and in combination with reamberin shows an antiatherogenic effect in the treatment of gestosis in the early postpartum period, the action of hydroxyethyl starch in combination with reamberin was much more pronounced. Key words: gestosis, blood lipoproteins, atherogenicity coefficient, reamberin.

Цель исследования — изучить возможность коррекции дислипопротеинемии при гестозе с помощью реамберина и гид< роксиэтилкрахмала. Материал и методы. Обследовали 22 больных с гестозом в раннем послеродовом периоде. Боль< ные группы 1 (8 человек) получали стандартное лечение. Больным группы 2 (7 человек) дополнительно к стандартно< му лечению в 1<е сутки после родов проводили инфузию гидроксиэтилкрахмала в виде 6% раствора в количестве 5—6 мл/кг массы тела со скоростью 3 мл/мин. Больным группы 3 (7 человек) дополнительно вводили 1,5% реамберин, по вышеуказанной схеме непосредственно после инфузии гидроксиэтилкрахмала. Результаты обследования сопоставля< ли с данными, полученными при обследовании 8 родильниц после беременности и родов без патологии (4<я группа). В плазме крови определяли концентрацию триглицеридов, общего ХС и холестерина ЛПВП, ЛПНП и ЛПОНП. Резуль� таты и обсуждение. У всех родильниц с гестозами обнаружили гипертриглицеридемию и повышенный уровень ХС ЛПОНП при сниженной концентрации ХС ЛПВП. Умеренно повышенный уровень триглицеридов и общего ХС наблю< дали и у пациенток при отсутствии гестоза. Действие гидроксиэтилкрахмала снижало концентрацию триглицеридов к 3—4<м суткам послеродового периода. В присутствии комплекса гидроксиэтилкрахмала с реамберином наблюдали до< стоверное снижение концентрации триглицеридов, ХС ЛПОНП и ХС ЛПНП и существенный рост уровня ХС ЛПВП. К 3—4<м суткам после родов в группе 1 наблюдали значительный рост коэффициента атерогенности, достоверный по сравнению с исходным уровнем. Действие гидроксиэтилкрахмала предотвращало возрастание коэффициента атеро< генности, комплекс гидроксиэтилкрахмала с реамберином достоверно снижал величину этого показателя и нормализо< вал его к 3—4<м суткам после родов. Заключение. Гидроксиэтилкрахмал и комплекс гидроксиэтилкрахмала с реамбе< рином проявляют антиатерогенный эффект при лечении гестозов в раннем послеродовом периоде, причем действие комплекса гидроксиэтилкрахмала с реамберином более выражено. Ключевые слова: гестозы, липопротеиды крови, ко< эффициент атерогенности, реамберин. Objective: to study whether reamberin and hydroxyethyl starch may be used to correct dyslipoproteinemia in gestosis. Subjects and methods: Twenty

Objective: to establish the common regularities and etiological features of lipid metabolic changes in critical conditions of various etiology. Subjects and materials: 102 patients with sepsis, severe mechanical injury, and moderate gestosis were examined. The patients were divided into groups according to the etiology and severity of a condition. The patients’ age was also kept in mind in severe mechanical injury. The plasma concentrations of triglycerides (TG), total cholesterol, high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), and very low-density lipoprotein cholesterol (VLDLC) were determined. Results. There were atherogenic changes in lipid metabolism, which were characterized by a rise in the level of TG and accordingly VLDLC with decreased HDLC concentrations. In sepsis and gestosis, the changes in TG and VLDLC levels occurred in the range of the concentrations exceeding the physiological normal values. In sepsis, the positive changes in these parameters were associated with a good clinical outcome. In mechanical injury, the increase in TG and VLDLC levels occurred in the physiological normal range and it was more significant in fatal outcome. Conclusion. Atherogenic changes in lipid metabolism are a common regularity in critical conditions, they are characterized by an increase in TG and VLDLC levels with decreased HDLC concentrations, show various trends, and occur in different ranges of concentrations depending on the etiology and severity of a condition. Key words: dyslipidemia, atherogenesis, critical conditions, severe mechanical injury, gestosis, sepsis.

Objective: to study changes in lipid metabolic parameters during surgical myocardial revascularization and the informative value of the parameters as predictors of the postoperative course of the disease. Subjects and methods: The concentrations of triglycerides, total cholesterol (TC), and cholesterols of high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) were measured in 37 patients with acute coronary syndrome and chronic ischemic heart disease who had undergone surgical myocardial revascularization. Results and discussion. In all the examinees, the preopera-tive concentrations of TC and LDL cholesterol were higher than the recommended target values in cardiovascular diseases. By discharge the total concentration of proatherogenic particles significantly decreased only in acute coronary syndrome. In chronic ischemic heart disease, the total concentration of blood proatherogenic particles remained unchanged as compared with the baseline values. If postoperative complications occurred, surgery was preceded by the development of hypertriglyceridemia and hyperprebetalipoproteinemia and the proatherogenic nature of the lipoprotein profile increased by discharge due to the reduced concentration of antitherogenic HDL. Conclusion. Concomitance of postoperative complications with preoperative positive changes in the concentrations of triglycerides and VLDL allows these parameters to be used as predictors of the postoperative course of the disease. To facilitate the course of the disease, it is expedient to correct dyslipoproteinemia before and after surgical myocardial revascularization. Key words: lipoproteins, dyslipoproteinemia, atherogenic particles, myocardial revascularization, atherogenicity index.

Objective: to study the blood atherogenic potential in women with gestosis in early puerperium to assess a risk of cardiovascular diseases. Subjects and methods: The concentrations of triglycerides, total cholesterol, and cholesterols of high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein were measured in 32 patients aged 25—30 years in early puerperium. The data of examining women with gestoses (Group 3) were compared with the results of examining those after physiological pregnancy delivered both during vaginal delivery (Group 1) and via cesarean section (Group 2). Results and discussion. The puerperas with gestosis had significant hypertriglyceridemia and hyperbetacholesterolemia throughout the follow-up. There were no significant abnormal concentrations of low-density lipoproteins. In gestosis and after cesarean section, there was an almost double fall in the blood concentration of high-density lipoproteins to the level that assigned these patients to a group at risk for cardiovascular diseases. In these patients, the cholesterol atherogenicity coefficient was drastically increased. A moderate increase in the blood atherogenic potential in early puerperium was noted both during normal pregnancy and at normal labor. Conclusion. Concomitance of hypertriglyceridemia and hyperprebetacholesrerolemia with the low concentration of high-density lipoproteins suggests that after prior gestosis, cardiovascular complications may develop, presenting a high death risk. It is concluded that it is necessary to monitor the blood lipoprotein spectrum during gestation and puerperium and atherogenic dyslipoproteinemia can be corrected in case of its detection. Key words: gestosis, puerperium, dyslipoproteinemia, hypertriglyceridemia, hyperprebetacholesterolemia.

Objective: to examine gender-related differences in the postresuscitative brain functional and structural changes.Materials and methods. Congenital and acquired behaviors were studied in 100 adult albino rats of both sexes in the control and after experienced 12-min cardiac arrest during 3 months (6 tests); the conditions of highly sensitive to ischemia of cerebral formations were subject to neuromorphological quantitative studies, and biochemical plasma parameters were determined.Results. Sexual differences in the integrative activity of the brain, in the state of neuronal populations in different regions of the hippocampus and cerebellum, and in plasma biochemical parameters were established in normalcy. Common and gender-related functional and structural changes of the brain and changes in plasma biochemical parameters were revealed in the postresuscitative period.Conclusion. Further studies of the gender-related mechanisms of development are required to develop specific methods for the prevention and therapy for disease.

Changed lipid metabolic parameters in parallel with a blood loss volume were studied in patients with severe mechanical injury, which were comparable by the APACHE II scale severity. The study indicated the elevated levels of atherogenic fractions with the increased blood loss volume that was significantly pronounced when it was 37 ml/kg or more. A rise of the cholesterol atherogenicity index also occurred with the higher blood loss volume. Changes in the lipoprotein spectrum with a blood loss volume of 25 ml/kg or more preserve within a rehabilitative month. In severe mechanical injury, normalization of the lipid spectrum promotes the use of perfluorane. It is concluded that blood loss predominantly affects the lipoprotein spectrum in severe mechanical injury.

The changes in the parameters of the transporting capacity of albumin, in some biochemical plasma parameters, and in the impact of low-energy laser irradiation on the studied parameters were examined in patients with severe mechanical injury in the early posttraumatic period. Thirty patients aged 17 to 70 years who had a health status of 78 to 98 scores by the APACHE-III scale were examined. The results indicated that as a consequence of prior hypoxia of mixed genesis and subsequent reperfusion and later on due to the development of endogenous intoxication, there were changes in the transporting capacity of albumin and in the de Ritis coefficient, a reduction in cholesterol concentrations, and increases in the levels of triglycerides and in the activity of gamma-glutamyl transpeptidase. Early quantum hemotherapy as a part of complex treatment makes it possible to prevent the progressive deterioration of the transporting capacity of plasma albumin, the critical reduction in the effective concentration of albumin, contributes to a more rapid recovery of the lowered levels of cholesterol and to a further increase in the activity of gamma-glutamyl transpeptidase, which is indicative of the recovered biosynthetic activity of the liver and its enhanced detoxifying activity.

Objective: to study the regularities of postpartum blood biochemical changes in varying severity gestosis.Subjects and methods: thirty-five females were examined in the puerperium. Blood was taken on postpartum days 1 and 3—4. The parameters of hepatic and renal function and lipid parameters were determined.Results. Higher levels of creatitine and urea and a more pronounced increase in the concentration of triglycerides and very low-density lipoproteins were observed in moderate gestosis than in normal physiological pregnancy. All the examinees were recorded to have low total protein levels within the first 24 hours after labor. Parturient women with moderate gestosis showed negative changes in protein concentrations throughout the study. Severe gestosis was characterized by multiple increases in bilirubin concentrations and, in case of death, these are also added by higher alanine aminotransferase and aspartate aminotransferase activities.Conclusion. Hypoproteinemia, hypocalcemia, elevated levels of triglycerides and very low-density lipoproteins and a simultaneous decrease in high-density lipoproteins are preserved in moderate gestosis in the early puerperium.

A parallel study of changes in the activity of transaminases and the parameters of lipid metabolism was conducted in patients with sepsis or septic shock, receiving renal replacement therapy. The multiple baseline increase in the activity of gamma-glutamyltranspeptidase was observed in about 50% of the patients and the elevated level of triglycerides and very low density-lipoprotein cholesterol in all the examinees. In case of the baseline multiple increased activity of gamma-glutamyltranspeptidase as compared with the normal physiological values, the probability of a good clinical outcome was some 67%, in the survivors, the activity of the enzyme significantly increasing during therapy. In the absence of the baseline multiple increased activity of gamma-glutamyltranspeptidase, there was a good clinical outcome provided that there were positive changes in triglycerides and very low-density lipoprotein cholesterol during therapy and its probability was about 33%. It is concluded that the activity of gamma-glutamyltranspeptidase and the concentration of triglycerides and very low-density lipoprotein cholesterol may be used to evaluate the efficiency of treatment and as predictors of the outcome of treatment in patients with sepsis and septic shock.

The changing indices of lipid metabolism were studied in patients with sepsis who were undergoing the substitution renal therapy. A sharp reduction of high-density lipoproteins (HDLP) and a higher concentration of triglyceride (TG) and of an extremely low-density lipoproteins (ELDLP) were shown in the blood plasma of such patients irrespective of a clinical outcome. The positive dynamics of TG and ELDLP concentrations as observed in the process of treatment was considered to be a good prognostication sign in sepsis and septic shock.

The paper contains the study results of some lipid-metabolism indices in patients with severe mechanical injury. Changing concentrations of total cholesterol, triglycerides and of different lipoprotein fractions in blood plasma are demonstrated. It was established that the investigated lipid-metabolism indices reflect a degree of liver malfunction in severely impaired homeostasis. It can be stated on the basis of comparing the study results with the clinical outcome that the dynamic concentration of total cholesterol in blood plasma is an important prognostication factor. Changing ratios of high-density lipoproteins, low-density lipoproteins and extra-low-density lipoproteins were observed in survivors yet by day 15, which is indicative of a commencing dislipidemia.

Changes in the plasma lipoprotein spectrum were studied in patients with severe mechanical trauma. These changes were shown to be associated with the severity of injury and with the age of patients. The steady-state reduction in the plasma concentrations of cholesterol in patients aged under 55 years who have a serious mechanical trauma may be considered to be a poor predictor. In patients above 55 years, the severity of their condition may be judged from the changes in the concentration of high density lipoproteins: the positive changes in this parameter are indicative of a good clinical outcome.

Plasma lipid metabolism was studied in critical patients with severe combined injuries. Decrease in cholesterol concentration and increase in triglyceride concentrations were more pronounced in patients with lethal outcomes. The authors conclude that plasma cholesterol and triglyceride concentrations can be used as prognostic signs in patients with severe combined injuries.

Biochemical parameters characterizing visceral functions were measured in the plasma of rats with brain ischemia induced by double occlusion of the carotid arteries. Functional insufficiency of the viscera is gradually forming in the course of occlusive ischemia of the brain. Functional insufficiency of the liver was observed in animals with severe neurological deficiency and subsequent lethal outcome. In rats resistant to ischemia, visceral dysfunctions develop in a certain succession, starting from the pancreas and followed by the myocardium, liver, and kidneys.