Endothelial Dysfunction in the Pathogenesis of Chronic Inflammatory Processes of the Internal Genital Organs in Women

Abstract

The objective of the work: to study the changes of the functional activity of the endothelium and the plasma-coagulation link of hemostasis in women with chronic inflammatory processes of the internal genital organs (CIPIGO) with and without varicose veins of the small pelvis (VVSP).Materials and methods: 68 women with chronic inflammatory processes of the internal genital organs against the background of varicose veins of the small pelvis (group 1); 52 women with chronic inflammatory processes of the pelvic organs without varicose veins of the small pelvis (group 2); 30 practically healthy women (control group) were examined before and after the treatment. The age of women was between 18 and 45 years old. All the patients of the study groups received the treatment offered by us, which included a diosmine-containing phlebotropic preparation normoven, 500 mg twice a day in continuous mode and a donor of nitric oxide tivortin aspartatum, 5 ml 3 times per os for 14 days each month during six months.Determination of concentration of endothelin-1, prostacyclin was performed by immunoassay using a set of reagents from the firm “Biomediсa” (Austria); the determination of D-dimers in blood plasma was performed by latex-test of the firm “Organon-Tekhnika”.Results of workIn women with CIPIGO with and without VVSP, the increased production of endothelin-1, which has a pro-aggregate and pro-inflammatory effect, was determined. At the same time, the decrease of the synthesis of prostacyclin, which has anti-aggregant properties, was noted. In evaluating the indicators of coagulograms in patients of the studied groups, the propensity for hypercoagulation was revealed, as evidenced by an increase in the level of fibrinogen and a rise of index of the phospholipid-dependent coagulation tests. The decrease of the percentage of fibrinolytic blood activity and the increase in plasma concentration of the molecular marker of thrombophilia D-dimer can be considered as activation of intravascular coagulopathy and the presence of endothelial dysfunction.Conclusions: 1. Our studies found endothelial dysfunction and violations of the plasma-coagulation linkage of hemostasis in both studied groups. 2. After the performed treatment, the improvement of the functional activity of the endothelium and normalization of the main parameters of the plasma-coagulation linkage of hemostasis were observed.