Антитромбоцитарна терапія ішемічної хвороби серця: патогенетичні аспекти, ризики та діагностично-терапевтична стратегія

Участь тромбоцитарного гемостазу у атерогенезі та розвитку атеротромботичних ускладнень серцево-судинних захворювань. Дослідження основних проблем антитромботичної терапії при ішемічній хворобі серця. Генетична детермінованість розвитку резистентності.

Рубрика Медицина
Вид диссертация
Язык украинский
Дата добавления 25.06.2018
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4. З метою індивідуального прогнозування ризику розвитку серцево-судинних подій у хворих з високою реактивністю тромбоцитів на тлі прийому АСК рекомендовано молекулярно-генетичне дослідження крові для встановлення наявності мінорного алелю генів - кандидатів (гену циклоксигенази-1 C50T гена PTGS1 та генів тромбоцитарних рецепторів: Т1565С гена тромбоцитарного рецептора ITGB3, T924C гена тромбоксанового рецептора (TBXA2R), C807T гена глікопротеїна Ia ITGА2) (патент № u201409409).

5. Для оптимізації антитромбоцитарної терапії у пацієнтів ІХС в поєднанні з цукровим діабетом запропоновано диференційований підхід, при якому у складі стандартної комплексної терапії режим АСК призначається після оцінки тромбоцитарних індексів (МPV, PDW), і, якщо значення показників тромбоцитарного гемостазу знаходяться у межах встановлених нормальних значень, попередньо призначену добову дозу АСК розподіляють на 2 прийоми на добу, а якщо значення одного або обох показників тромбоцитарного гемостазу перевищують верхню межу встановлених нормальних значень, попередньо призначену дозу підвищують в 2 рази та розподіляють на 2 прийоми на добу.

6. Для профілактики НССП при стабільному перебігу ІХС рекомендовано покроковий персоніфікований підхід до призначення антитромбоцитарної терапії з урахуванням тромботичного і геморагічного ризиків у пацієнта.

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ПЕРЕЛІК УМОВНИХ ПОЗНАЧЕНЬ

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