Оценка влияния инфузионной терапии на динамику эндотелина-1 у больных с острым ишемическим инсультом

A. I. Semenenko; N. O. Semenenko; Н. I. Hrebtii; S. L. Malуk; R. Ya. Bodnar; O. M. Hinhuliak

doi:10.14739/2310-1210.2019.1.155796

Authors

A. I. Semenenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
N. O. Semenenko National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
Н. I. Hrebtii Higher State Educational Establishment “Bukovinian State Medical University”, Chernivtsi, Ukraine,
S. L. Malуk National Pirogov Memorial Medical University, Vinnytsia, Ukraine,
R. Ya. Bodnar Horbachevsky Ternopil State Medical University, Ukraine,
O. M. Hinhuliak Higher State Educational Establishment “Bukovinian State Medical University”, Chernivtsi, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2019.1.155796

Keywords:

stroke, solutions, endothelins, HES 130, HAES-LX-5 %, 0.9 % NaCl, mannitol

Abstract

The impact of infusion solutions on endothelial damage correction in acute ischemic stroke (AIS) remains an insufficiently studied.

Purpose. To investigate the dynamics of endothelin-1 as one of the main markers of vasoconstriction and endothelial dysfunction (ED) with the use of 0.9 % NaCl, HES 130, HAES-LX-5 % and mannitol in patients with AIS.

Materials and methods. The study included 32 patients with AIS. As the investigated solutions were used: colloid hyperosmolar HAES-LX-5 % (Gecoton), colloid isoosmolar hydroxyethylstarch 6% 130/04 (HES 130), hyperosmolar mannitol 15 %, isoosmolar 0.9 % NaCl. The control group consisted of patients who received only 0.9 % NaCl, comparison group patients received 0.9% NaCl + HES 130 or 0.9 % NaCl + HAES-LX-5 %, or 0.9 % NaCl + mannitol. The level of endothelin-1 (EN-1) served as a vasoconstriction marker of ED at a fixed time (days 1, 4 and 7).

Results. Infusion therapy with only 0.9 % NaCl negatively affected the level of EN-1, since its level was 3.17 times increased on the 7th day of observation in comparison with the 4th day (P < 0.05). In the course of seven-day treatment with mannitol, a sharp increase in EN-1 serum level on average 3.73 and 3.48 times higher on day 7 (P < 0.05) compared to days 1 and 4, respectively, was observed. Infusion therapy with HES 130 and HAES-LX-5 % solutions produced a moderate depressing effect. So, the HAES-LX-5 % and HES 130 groups demonstrated a trend towards a decrease in ЕN-1 level (P > 0.05) at the end of observation in comparison with mannitol and 0.9 % NaCl groups, which showed a paradoxical increase in its level at the 7th day of infusion.

Conclusions. The dynamics of EN-1 level as the main vasoconstrictor marker of ED were negative in the group of patients with 0.9 % NaCl and mannitol: its level was 3.17 and 3.48 times increased in the 0.9 % NaCl and mannitol groups (P < 0,05), respectively, on day 7 compared to day 4 of observation. Intensive therapy with HAES-LX-5 % and HES 130 had a better depressing effect on an increase in EN-1 level than other solutions.

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