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[4; 5]. - - , [6-10]. , - - , 47 1. ( ), ( ) ( ) -2 ( ) -2 ( - ) ( - ) . , -2 ( ) [15; 16], -2 - ( 7 ) ( ) Medata Holter ECG tracer (SN MEBA 734744 (USA) (V 3 , V 5 VF) S-T [17; 18]. - - Excel 2007 [3]. - ( ) (m); - ( ), (SD) (SE), , - , - 2 . . r 0,25-0,35 , r 0,36- 0,70 - , r - 0,71 0,99 - . - t- . <0,05. - . - - ( ) - ( ) - 1. 1. - ( ) ( ) -2 (n = 73) -2 (n = 86) (n = 49) (n = 24) (n = 52) (n = 34) < 9 15 (9,43%) 6 (3,77%) 1/2 26 (16,35%) 20 (12,58%) 1/2 21 (13,21%) 1/2 46 (28,93%) 1/2 > 9 34 (21,38%)* 18 (11,32%)* 30 (18,87%) 17 (10,69%) 52 (32,7%) 40 (25,16%) 34 (21,38%) 28 (17,61%) 30 (18,87%) 17 (10,69%) 62 (38,99%) 1/2 29 (18,24%) 1/2 ( / ) 22 (13,84%) 19 (11,95%) 1/2 13 (8,18%) 8 (5,03%) 1/2 41 (25,79%) 21 (13,21%) ( / ) 12 (7,55%) 9 (5,66%) 6 (3,77%) 2 (1,26%) 21 (13,21%) 1/2 8 (5,03%) 1/2 : 1/2 – -2 ( -2) (p<0,05); * – (p<0,05) 0 39 38 28 3 1 -73 + . -n=49 n=24 44 34 21 1 0 + . -86 48 1, -2, , 9 -2 (p<0,05). - -2. - -2. - 2. 2, , - , , 15 60 . - . - -2 ( - - - ), ( -2) - ( ). - - - , - , , - - -2, - ( -2) . , , , - . - ( 9%) - . - ( ) - , - -2 ( -2) . 3. 2. ( %- ) (M + m) -2 ( ) ( -2) -2 (n = 73) (n = 86) (n = 49) (n = 24) (n = 52) (n = 34) 3,21 + 0,27 (2,7 – 3,7) 3,25 + 0,25 (2,8 – 3,7) 3,21 + 0,29 (2,7 – 3,7) 3,39 + 0,29 (2,7 – 3,9) 3,22 + 0,27 (2,7 – 3,7) 3,31 + 0,31 (2,7 – 3,9) (%) 15 6,95 + 1,21 (1/2) (3,71 – 11,19) 6,39 + 0,81 (1/2) (4,93 – 9,91) 10,31 + 0,98 (1/2) (7,3-13,6) 9,21 + 0,81 (1/2) (7,2–12,8) 6,76 + 1,07 (3,7 – 11,19) (1/2) 9,78 + 0,99 (7,2 – 13,6) (1/2) 60 8,33 + 0,97 (1/2) (6,22 – 10,42) 7,61 + 0,89 (1/2) (6,27 – 9,55) 14,51 + 0,88 (1/2) (9,53 – 19,52) 16,77 + 0,96 (1/2) (8,98 – 21,14) 8,07 + 0,99 (6,22 – 10,42) (1/2) 15,85 + 0,99 (8,98 – 21,14) (1/2) : (1/2) – -2 ; – ; – %- 49 3. ( +m) -2 ( ) -2 : 159 (100%) : n = 101 (63,52%) : n = 58 (36,48%) -2 (n -2 = 73; n = 49; n = 24) (n = 86; n = 52; n = 34) -2 + (n = 39) -2 (n = 34) + (n = 44) (n = 42) 63,48 + 8,12 (27 - 75) 56,41 + 7,82 (27 - 67) 61,75 + 7,14 (44 - 81) 56,54 + 6,58 (44 - 69) 59,52 + 9,13 (27 - 75) 58,99 + 7,23 (44 - 81) : n -2 – -2; n – ; n – ; n – ; -2+ - -2 ( ); -2 - -2 ; + - ; - 3, . - , - - , - - - -2 + , ( 2) – - . , - - -2, , , - , - , - - , - - , – - -2 -2 - . - - ( ) ( - ) - , , -1 - - , - . - , -1 , , , ( 4). - - - , - , , -1 – (r=-0,7843, p<0,01; r=-0,7214, p<0,05, ). ST 7- , ST -2 -2 ( 5). 5, -2 ST: (p<0,05). , , -2 - 50 4. ( ) -1 ( -1) (M+m) (n = 85) (n = 74) (n = 53) (n=32) n = 48) (n = 26) , / 8,73 + 2,25 (5,4 – 12,56) 1/2 9,44 + 2,73 (6,2 – 18,4) 1/2 16,25 + 2,79 (6,5 – 36,8) 1/2 17,32 + 2,67 (6,6 – 38,4) 1/2 9,07 + 2,74 (5,4 – 18,4) 1/2 16,86 + 2,35 (6,5 – 38,4) 1/2 -1, / 7,63 + 1,45 (6,11 – 9,56) 1/2 8,91 + 1,76 (6,22–9,65) 1/2 11,97 + 1,37 (6,93 – 12,82) 1/2 13,61 + 1,04 (6,99–14,24) 1/2 7,46 + 1,78 (6,11 – 9,65) 1/2 12,74 + 1,92 (6,93 – 14,24) 1/2 : 1/2 – (p<0,001) 5. ST -2 ( ) -2 -2 (n = 73) (n = 84) (n = 49) (n = 24) (n = 52) (n = 34) ST 136 (85,53%) 1/2 142 (89,31%) 1/2 64 (40,25%) 1/2* 33 (20,75%) 1/2* 278 (174,84%) 1/2 97 (61,0%) 1/2 : ST – ST ; 1/2 – -2 ( -2) (p<0,05); * - (p<0,05) , -2, , - . -2 - , - , - - , . 1. -2 - , - ( ) - , -2 , - - ; 2. - ( ) -1( -1) , - - -1 (r=-0,7843, p<0,01; r=-0,7214, p<0,05, ). ; 3. - ( - ) - - - ( ST - 278 -2 97 . 51 1. Goraya T.Y., Leibson C.L., Palumbo P.J. et al. Coronary atherosclerosis in diabetes mellitus: a population-based autopsy study / J. Am. Coll. Cardiol. – 2002. – Vol. 40 (5). – pp. 946-953. 2. Haffner S.M., D'Agostino R.Jr., Saad M.F. et al. Carotid artery atherosclerosis in type 2 diabetic and nondiabetic subjects with and without symptomatic coronary artery disease (The insulin resistance atherosclerosis study) / Am. J. Cardiol. – 2000. – Vol. 85. – p. 1395-1400. 3. Stout R.W. Diabetes, atherosclerosis and aging / Diabetes Care. – 1990. – Vol. 13 (Suppl. 2). – pp. 20- 23. 4. . . 2 . . . . . – 2008. – 240 . 5. . ., . . . / / . . . (IV , . XI) // . – . – 1997. – c. 195-210. 6. . ., . ., . . . ( 2339312, : 27.11.2008) 7. . . - . . . . . - - . – 2006. – 346 . 8. Celermajer D.S. Testing endothelial function using ultrasound / J. Cardiovasc. Pharmacol. – 1998. – Vol. 32 (Suppl 3). – pp. S29-32. 9. Graham M., Daly L., Refsum H. et al. Plasma homocysteine as a risk factor for vascular disease: the European concerted action project / J.A.M.A. – 1997. – Vol. 277 (22). – pp. 1775-1781. 10. Hankey G.J., Eikelboom J.W. Homocysteine and vascular disease / Lancet. – 1999. – Vol. 354. – pp. 407-413. 11. Luscher T.F., Creager M.A., Beckman J.A. et al. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: Part II / Circ. – 2003. – Vol. 108 (13). – pp. 1655-1661. 12. Yamasaki Y., Kodama M., Nishizawa H. et al. Carotid intima-media thickness in Japanese type 2 diabetic subjects: predictors of progression and relationship with incident coronary heart disease / Diabetes. Care. – 2000. – Vol. 23 (1310). – p. 1315. 13. . . : ( 2) / htpp:// the-filithlivejournal.com/175391.html 14. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications / Report of a WHO Consultation. – 1999. – 59 P. 15. Cohn P.F., Kannel W.B. Recognition, pathogenesis, and management options in silent coronary artery disease / Circ. – 1987. – Vol. 75. – p. 11-15. 16. Stone P.H., Chaitman B.R., McMahon R.P. et al. The Asymptomatic Cardiac Ischemia Pilot (ACIP) Study: relationship between exercise induced and ambulatory ischemia in patients with stable coronary disease / Circ. – 1996. – Vol. 94. – pp. 1537-1544. 17. Crawford M.H., Bernstein S.J., Deedwania P.C. et al. ACC/AHA guidelines for ambulatory electrocardiography: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines (Committee to Revise the Guidelines for Ambulatory Electrocardiography) // J. Am. Coll. Cardiol. – 1999. – Vol. 34. – pp. 912-948. 18. Kodama Y. Evalution of myocardial ischemia using Holter monitoring / Fukuoka-Igaku-Zasshi. – 1995. – Vol. 86 (7). – pp. 304-316. 52 Gurbanov Y.Z., Abbasova M.R, Rzayeva R.A., Novruzova M.S. Comparison of common carotid artery vascular pool condition with ischemic heart disease manifestation homocysteine exchange, vasomotor and productive activity of endothelium in patients with and without diabetes mellitus type 2 Department of Terapevtic and pediatric propedeutic, Azerbaijan Medical University, Baku Summary. In this article the results of the morphological-structural investigation of common, internal and external carotid arteries in comparison with simultaneously determined plasma levels of homocysteine, vasomotor, productive activity of endothelium and manifestations of ischemic heart disease (estimated by shifts of ST segment during 24 Holter EKG monitoring) of the patients with and without type 2 diabetes mellitus are presented. It is shown, that in patients with 2 type diabetes mellitus and especially in combination of diabetes with arterial hypertension, vasomotor and productive activity of endothelium are seriously damaged. Indicated pathological findings are dependent on homocysteine plasma level and in the part of patients with endothelium dysfunction and homocysteine exchange violations the manifestations of ischemic heart disease are statistically reliable frequently occurred. Thus, the endothelium dysfunction in patients with diabetes mellitus type 2 especially in combination with arterial hypertension and high plasma homocysteine level can be considered as prognostic markers of the hidden coronary insufficiency, which needs careful monitoring of these patients condition and adequate additions to the traditional pharmacological therapy. E-mail: kamile.ceferova@mail.ru R yçi: tibb ü.e.d., professor V. . zizov |