Маркери дисфункції ендотелію у вагітних з варикозною хворобою вен нижніх кінцівок

Abstract

The objective: evaluation of the impact of the complex therapy on indexes of dysfunction of endothelium homocysteine and fibronectin in pregnant women with varicose veins of lower extremities. Patients and methods. 80 pregnant women with varicose veins of the lower extremities before and after treatment underwent the determination of the indexes of homocysteine and fibronectin. The main group – 42 pregnant women with varicose veins of the lower extremities received complex therapy within 30-36 weeks (medication with angioprotective effect, direct anticoagulant; graduated elastic compression; flavonoid with immunotropic effect); comparison group – 38 women with varicose veins of the lower extremities, received local heparin-contenting medication. The control group included 50 pregnant women without VVLE. Results. In analysis of the concentration of the homocysteine in blood plasma in pregnant women with varicose veins of the lower extremities the increase of the level was detected in 38% and 28.9% of the patients of the main group and comparison group accordingly; in control group – only in 2%. In main group the content of fibronectin was elevated in 69%; in comparison group in 71% of the patients, in control group – only in 6%. After treatment, the assessment of the markers of the endothelium dysfunction in examined groups was performed. The content of homocysteine decreased in 1.7 times in main group and only in 0.8% times in comparison group. The average level of fibronectin in main group decreased on 31.2% in comparison with benchmark; in comparison group its level decreased only on 12.2%. Conclusions. Thereby, we detected in third trimester in pregnant women with varicose veins of the lower extremities statistically credibly high indexes of homocysteine and fibronectin compared to the control group. Decrease of the level of homocysteine in 1.7 times and content of fibronectin in blood plasma in 1.5 times can be a sign of positive stabilizing effect on endothelium of blood vessels in suggested therapy. Key words: varicose veins of lower extremities, homocysteine, fibronectin, complex therapy.