Year 2010 Vol. 18 No 4

GENERAL AND SPECIAL SURGERY

YU.M. STOYKO, V.G. GUDYMOVICH, S.I. TRIFONOV, A.M. NIKITINA, M.V. NIKITIN

ENDOTHELIUM DYSFUNCTION IN THE PATIENTS WITH LOWER LIMBS CHRONIC VENOUS INSUFFICIENCY AND POSSIBILITY OF ITS CORRECTION

Objectives. To improve diagnostics, treatment and prognosis of the lower limbs chronic venous insufficiency (LLCVI) based on the study of the endothelium functional state.
Methods. 128 patients with LLCVI were included in the investigation. Changes of the endothelium dysfunction marker were studied – circulating endothelium cells (CEC). In 22 patients the study of the preparation «Antistax» effect on the endothelial dysfunction was performed.
Results. Study of the CEC number in the patients with intradermal and segmental subcutaneous varicosity without pathological veno-venous reset showed the features of the endothelium dysfunction in 30% of patients. The level of endothelemy in the patients with widespread varicosity with the reflux of superficial and perforant veins exceeded the normal limit in 26,4% patients. Trophic disorders of the shin skin and soft tissues weren’t associated with the increased endothelemy. Endothelium dysfunction wasn’t revealed in any patient with trophic ulcers. Endothelium dysfunction was detected in all patients (100%) in case of segmental subcutaneous varicosity with the reflux of superficial and perforant veins. After therapy with the preparation «Antistax» the normalization of the CRC number was observed accompanied with the marked improvement of the subjective sensations.
Conclusions. The obtained data testify to the significance of the endothelium dysfunction at LLCVI as well as to the necessity of including endothelium protectors in the treatment program.

Keywords: chronic venous insufficiency of the lower limbs, venous transformation, endothelium dysfunction, phlebotonics
p. 57-64 of the original issue
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