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Table EDVD of BA state and endotheliaemia level at patients with stable effort angina functional class III on the background of basic and complex treatment Value Initial Basic therapy Basic therapy + Perindopril BA diameter, 4,150,16 4,550,23 4,580,28 P0, initial, mm BA diameter, 4,910,24 5,420,27 6,310,25 P1-20, after test, mm P1-30, Vmax, initial, m\sec 0,920,03 1,020,04 1,170,18 P1-30, Vmax, after test, 1,310,15 1,510,16 2,310,12 P1-30, m/sec Vmin, initial, m/sec -0,210,02 0,120,08 0,250,06 P1-20, P1-30, Vmin, after test, 0,110,01 0,160,04 0,280,03 P1-30, m/sec TAMX, initial, 0,140,05 0,160,04 0,170,07 P0, m/sec TAMX, after test, 0,450,03 0,510,04 0,580,06 P0, m/sec PI, initial 8,910,04 9,680,03 9,180,02 P0, PI, after test 3,180,15 2,980,12 2,230,25 P1-30, RI, initial 1,190,02 1,130,05 1,780,06 P1-30, RI, after test 0,900,06 0,850,04 0,570,03 P1-30, EDVD of BA, % 3,821,23 8,122,48 10,842,36 P1-30, P2-30, DEC, cells in 100 8,11,2 5,91,2 4,51,1 P1-30, microliters P2-30, Thus, at addition to basic therapy of SA perindopril there is improving of a functional state of vessels and endotheliaemia level decreasing.

At perindopril influence studying on specific markers of an inflammation significant decrease in their concentration in a final point the researches significantly differs from initial and basal data (table 2) is noted. So, at perindopril addition to basic therapy, there were significant decreasing of the increased, in comparison with initial level, proinflammatory cytokines levels: TNF - - in 1,8 times, IL-1 - in 2, times, IL-6 - and 1,5 times ( 0,05). Also we determine increasing of anti inflammatory cytokines: IL-4 and IL-10, accordingly in 1,2 and 2,6 ( 0,05). At initial state this parameters has significantly low levels.

Correlation analysis revealed significant (P0,05) correlation relationship between endotheliaemia indexes dynamics and EDVD of BA against complex ISSNͲߠίȠ.2013.80..1..1 therapy with perindopril administration. So, endotheliaemia level decreasing was in direct correlation dependence (r = + 0,63, 0,05) with anti-inflammatory cytokine (IL-10) level, and inverse correlation with degree increasing of proinflammation cytokines - IL-1 (r =-0,53, 0,05) and IL-6 (r =-0,48, 0,05).

Increasing of EDVD of BA was in inverse correlation with dynamics of TNF - concentration (r =-0,56, 0,05) Table Specific markers of inflammation dynamics at patients with stable effort angina functional class III on the background of basic and complex treatment Value Initial Basic therapy Basic therapy + Perindopril TNF-, 76,915,83 59,245,63 40,784,85 P1-30, picogram/ml P2-30, IL-1, 62,144/96 48,444,56 31,422,65 P1-30, picogram/ml P2-30, IL-6, 47,365,84 42,245,65 32,143,64 P1-30, picogram/ml P2-30, IL-4, 20,236,87 22,143,86 25,524,28 P1-30, picogram/ml IL-10, 16,641/13 26,452,17 35,124,24 P1-20, picogram/ml P2-30, So, the obtained data indicates that perindopril addition to basic therapy of SA results not only in improvement of vessels functional state, but also have anti inflammatory influence that was detected in depressing of proinflammatory cytokines secretion and stimulation of anti-inflammatory mediators production.

CONCLUSIONS 1. At patients with stable effort angina of III functional class disturbances of EDVD of BA and increased levels of endotheliaemia were revealed that confirms endothelium involvement in pathological process.

2.There is significant (P0,05) correlation of the indexes reflecting endothelium state with specific inflammation markers activation: increasing of proinflammatory (TNF, IL-1, IL-6) and decreasing of anti-inflammatory (IL-4, IL-10) cutokines.

3. Complex therapy with perindopril administration at subjects with stable effort angina class III improved a endothelium functional state, that was evident by EDVD of BA increasing and endotheliaemia level decreasing and led to more significant anti-inflammatory action, than basic therapy.

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State Establishment "Zaporozhye medical academy of postgraduate education of Ministry of Health Care of Ukraine" INFLUENCE OF PERINDOPRIL ON VASOMOTOR ENDOTHELIAL FUNCTION AND INFLAMMATION MARKERS AT PATIENTS WITH ISCHEMIC HEART DISEASE The goal of the study was to investigate interrelation between changes of endothelium dependent vasodilatation (EDVD) of brachial artery (BA) and specific markers of an inflammation (TNF-, IL-1, IL-4, Il-6, IL-10) at patients with SA receiving perindopril as basic therapy.

61 patient of the age (62,14,2) year with verified SA III functional class (FC) of NYHA. All patients received the basic therapy and divided on to two groups. patients (1st group) who in the anamnesis had adverse effects or intolerance to ACEI, received only basic therapy. To 32 patient (2nd group) perindopril (prestarium, Servier, France) was administered (dose 8mg once daily). EDVD of BA and levels of specific markers of an inflammation was made right after hospitalization and in days. Statistical analysis of the obtained data was performed by means of program "STATISTICA 6.0".

216 ISSNͲߠίȠ.2013.80..1..1 At patients with stable effort angina of III functional class disturbances of EDVD of BA and increased levels of endotheliaemia were revealed that confirms endothelium involvement in pathological process. There were significant (P0,05) correlation of the indexes reflecting endothelium state with specific inflammation markers activation: increasing of proinflammatory (TNF-, IL-1, IL-6) and decreasing of anti-inflammatory (IL-4, IL-10) cytokines. Complex therapy with perindopril administration at subjects with stable effort angina class III improved a endothelium functional state, that was evident by EDVD of BA increasing and endotheliaemia level decreasing and led to more significant anti-inflammatory action, than basic therapy.

Keywords: ischemic heart disease, vasomotor endothelial function, cytokines, perindopril.

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13. Bent S. Antibiotics in acute bronchitis: a meta-analysis/S. Bent, S. Saint, E.

Vittinghoff, D.Grady// Am. J. Med.-1999. -Vol. 307. - P. 7 62.

14. Colodner R. Extended spectrum beta-lactamases: the end of cefalosporins? /R.

Colodner, R. Raz // Isr. Med. Assoc.J. - 2005.-Vol. 7.- P. 8 136.

15. Ishivada N. Characteristice of beta-lactamase-producting and amoxicillin clavulanat-resistent strains of H. influensae isolated /N. Ishivada //J. infect chemotherapy. - 1998. - Vol. 4. - P. 112-115.

16. Finch R.H. Antibiotic and chemotherapy: anti-infective agents and their use in therapy/ R.H. Finch, D. Greenwood, S.R. Norde, R.J. Whitley //Clin. Infect. Dis. 2005. Vol. 26. - P. 17-62.

17. Jacobs M.R. The Alexander Project 1998 2000: susceptibility of pathogens isolated from community- acquired respiratory tract infection to commonly used antimicrobial agents/M.R. Jacobs, D. Flemigham, P.C. Appelbaum et al.//J.

Antimicrob. Chemother.- 2003.- Vol. 52 (2).- P. 46-229.

18. Kozlov R. Current and future issues in resistance of respiratory pathogens: is the horizon still bright? 20 ESMID Congress, Vienna, Austria, 10-13 Apr. 2010/ R.

Kozlov //Clinical microbiology and infection.- 2010.- Vol. 16.- P. 42.

19. Macfarlane J. Prospective study of incidence, aetiology and outcome of adult lower respiratory tract illness in the community / J. Macfarlane, W. Holmes, P. Gard et al. // Thorax.- 2001.- Vol. 56.- P. 109-114.

20. Mylotte J.M. Nursing home-acquired pneumonia update of treatment options/ J.M. Mylotte // Drugs Aging. - 2006. - Vol. 23.- P.90 377.

21. Opal S.M. Molecular mechanisms of antibiotic resistance in bacteria / S.M.

Opal, A.A. Medeiros. - Philadelphia: Churchill Livingstone, 2004. 253 p.

22. Otto G. Predicting Antimicrobal resistance Pneumococcal infections / G. Otto, R. Vanderhool// Clinical Infections Diseas,- 2005.- Vol. 40.-P. 1288-1297.

23. Towner K.J. Mechanims of acquired resistance/ K.J, Towner // Clin. Infect.

Dis. - 2005. - Vol. 41. - P. 5-27.

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I.M. Fushtey, O.A. Savchenko, S.L. Podsevahina, A.I. Palamarchuk State Institution "Zaporozhye Medical Academy of Postgraduate Education Ministry of Health of Ukraine " RATIONAL ANTIBIOTIC TREATMENT OF PATIENTS WITH INFECTIONS OF THE LOWER RESPIRATORY TRACT The article highlights the urgent issues of microbial resistance to antibiotics. At present, the growth of microbial resistance to antibiotics is a problem all over the world. Antimicrobial resistance is of great socio-economic importance in the developed countries is seen as a threat to national security. Infections caused by resistant strains are characterized by heavy, prolonged course and significantly worsen the prognosis of patients with infectious disease. The main reason for the rapid growth of microbial resistance to antibiotics is their irrational use. Respiratory infections occupy the leading position in the overall morbidity and mortality.

Rational choice of antibiotics to treat infections of the lower respiratory tract requires the treating physician not only knowledge about the effectiveness of specific antibiotics against major pathogens of the disease, but also knowledge about the level of their regional resistance. The article presents the literature data on the level of world and regional resistance major pathogens of lower respiratory tract infections (S.pneumoniae, H. Influensae, M. Catarrhalis) to three groups of antibiotics: beta lactams, macrolides and respiratory fluoroquinolones. Based on these data, it was concluded that to date, for the treatment of infections of the lower respiratory tract by one of the major antibiotic is amoxicillin / clavulanate.

Key words: resistance, antibiotics, infections of the low respiratory ways.

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// . 2009. - 2 . 55 2. .. , / .. // . . 2009. 9(63) . http://www.urmj.ru/2009/arh9_63.htm 3. ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group (2002) Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). // JAMA. 2002. - Vol. 288(23). . 29812997.

4. Cheung B.M. Relationship between the metabolic syndrome and the development of hypertension in the Hong Kong Cardiovascular Risk Factor Prevalence Study-2 (CRISPS2) / B.M. Cheung, N.M. Wat, Y.B. Man // Amer. J.

Hypertens. 2008. Vol. 21, 1. P. 17-22.

5. Colussi G. Insulin resistance and hyperinsulinemia are related to plasma aldosterone levels in hypertensive patients / G. Colussi, C. Catena, R. Lapenna [et al.] // Diabetes Care. 2007. Vol. 30. P. 2349-2354.

6. Dahlof B. ASCOT Investigators (2005) Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. / B. Dahlof, P.S. Sever, N.R. Poulter [et al.] // Lancet/ 2005. - Vol. 366(9489). . 895906.

7. Mancia G. Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). / G. Mancia, G. De Backer, A. Dominiczak [et al.] // J. Hypertens. 2007. - Vol. 25(6). . 1105 1187.

8. Parving H.H. AVOID Study Investigators. Aliskiren combined with losartan in type 2 diabetes and nephropathy / H.H. Parving, F. Persson, J.B. Lewis [et al.] // N.

Engl. J. Med. - 2008. - Vol. 358 (23). - S. 2433 - 2446.

234 ISSNͲߠίȠ.2013.80..1..1 9. Pepine C.J. INVEST Investigators (2003) A calcium antagonist vs a non calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. / C.J. Pepine, E.M. Handberg, R.M. Cooper-DeHoff et [al.] // JAMA.

2003. - Vol. 290(21). . 28052816.

10. Rahmouni K. Obesity-associated hypertension / K. Rahmouni, M.L.

Correia, W.G. Haynes, A.L. Mark // Hypertension. 2005. Vol. 45. P. 9-17.

11. Reaven G.M. Insulin resistance, cardiovascular disease, and the metabolic syndrome / G.M. Reaven // Diabetes Care. 2004. Vol. 27. P. 1011 1012.

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I.M.Fushtey, S.L.podsevahina, A.I.Palamarchuk, O.A.Savchenko State Institution "Zaporozhye Medical Academy of Postgraduate Education Ministry of Health of Ukraine " INFLUENCE OF COMBINED ANTIHYPERENSIVE THERAPIES ON BLOOD PRESSURE DAILY PROFILE THE METABOLIC STATUS AND QUALITY OF LIFE AT PATIENTS WITH THE METABOLIC SYNDROME AND OBESITY 236 ISSNͲߠίȠ.2013.80..1..1 42 patients with an arterial hypertension of stage I (25 % of patients) and II degrees (75 %), a metabolic syndrome and abdominal type of obesity - 20 women and 22 men (middle age (63,81,7) years) with duration of disease (9,480,65 year) were investigated. After of the initial data registration combination therapy with perindopril and indapamide (Nolip[rel, Servier) was administered - perindopril 2 mg, indapamide - 625 mkg and noliprel-forte - perindopril - 4 mg, indapamide - 1, mg.). Titration was finished on 2 mg perindopril and indapamide - 625 mkg at 47,5 % of patients, on 4 mg perindopril and 1,25 mg indapamide - at 52,5 % of patients.

Repeated research was performed in 6 months of therapy. Target blood pressure levels reached 94,5 % of patients. According to blood pressure daily monitoring data there were significant improvement of levels and speed of morning increasing of blood pressure and its variability. Long-lasting therapy with perindopril and indapamide combination had modulating influence on various variants of a day-night rhythm of arterial pressure with its normalisation at the majority of patients. By results of our research it is revealed that the arterial hypertension at patients with a metabolic syndrome and abdominal obesity is interdependent to development proatherogenic status and correlated with carbohydrate metabolism. After 6 months treatment period there was reduction of atherogenic potential of a blood plasma and significant decrease in levels of insulin and glucose (P0,001). The insulinresistance index has decreased for 16,7 % (P 0,01). Significant improvement of life quality indexes - improvement of indexes of physical state of health, working capacity, psychologic abilities and a degree of manifestation of negative psychologic state of health, and also ability to social contacts is noted.

Keywords: arterial hypertension, blood pressure daily profile, metabolic syndrome, lipid and carbohydrate metabolism, quality of life, perindopril, indapamide.

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CHANGES IN ENDOTHELIUM VASOMOTOR FUNCTION UNDER THE ACTION OF IVABRADINE AT IHD IN OPERATED ONCOLOGY WOMEN. ovalyova A., Kovalyova O.

DISTINCTIONS IN ORIENTATION OF PULSE LOW-FREQUENCY ELECTRIC CURRENT INFLUENCE ON CARDIOVASCULAR SYSTEM FUNCTIONAL CONDITION AT TRAINED AND UNTRAINED PERSONS.. . .

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INFLUENCE OF PERINDOPRIL ON VASOMOTOR ENDOTHELIAL FUNCTION AND INFLAMMATION MARKERS AT PATIENTS WITH ISCHEMIC HEART DISEASE .., .., .., ..

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