Автореферат и диссертация по медицине (14.00.05) на тему:Наследственные дефекты в системе гемокоагуляции как факторы риска тромбообразования. Эффективность и безопасность антикоагулянтой терапии варфарином

Список сокращений.

ВВЕДЕНИЕ.

ГЛАВА 1 ОБЗОР ЛИТЕРАТУРЫ

1.1. Виды и распространенность тромбофилий, определяющих нарушения в плазменном и тромбоцитарном звеньях системы гемостаза.

1.2. Тромбофилия, ассоциируемая с гипергомоцистеинемией.

1.3. Факторы, влияющие на пенетрантность заболевания у носителей генетических мутаций, повышающих прокоагулянтный потенциал крови.

1.4. Клинические проявления тромбофилий.

1.5. Профилактика клинических проявлений тромбофилий.

ГЛАВА

МАТЕРИАЛЫ И МЕТОДЫ ИССЛЕДОВАНИЯ

2.1. Критерии включения в исследование.

2.2. Методы исследования.

2.3. Методы лечения.

2.4. Статистический анализ.

РЕЗУЛЬТАТЫ СОБСТВЕННЫХ ИССЛЕДОВАНИЙ

ГЛАВА

КЛИНИЧЕСКАЯ ХАРАКТЕРИСТИКА ОБСЛЕДОВАННЫХ !

ПАЦИЕНТОВ

3.1. Основная и контрольная группы при изучении факторов риска венозных тромбозов.

3.2. Основная и контрольная группы при изучении факторов риска ишемических кардиоэмболических нарушений мозгового кровообращения у больных с фибрилляцией и предсердий.

3.3. Основная и контрольная группы при изучении факторов риска тромбозов сосудистого доступа у лиц с терминальной ХПН, находящихся на лечении программным гемодиализом.

ГЛАВА

РАСПРОСТРАНЕННОСТЬ ГЕНЕТИЧЕСКИХ ДЕФЕКТОВ В СИСТЕМЕ ГЕМОКОАГУЛЯЦИИ, ГИПЕРГОМОЦИСТЕИНЕМИИ И ЧАСТОТА ПРИОБРЕТЕННЫХ ФАКТОРОВ РИСКА У БОЛЬНЫХ С

ВЕНОЗНЫМИ ТРОМБОЗАМИ

4.1. Распространенность мутаций в генах факторов

V (G1691А - Leiden), II (G20210A) и МТГФР у больных с венозными тромбозами и у здоровых лиц.

4.2. Распространенность гипергомоцистеинемии и ее связь с мутациями в гене МТГФР у больных с венозными тромбозами и у здоровых лиц.

4.3. Приобретенные факторы риска тромбозов у больных с венозными тромбозами.

ГЛАВА

ФАКТОРЫ РИСКА ИШЕМИЧЕСКИХ КАРДИОЭМБОЛИЧЕСКИХ НАРУШЕНИЙ МОЗГОВОГО КРОВООБРАЩЕНИЯ У БОЛЬНЫХ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ

5.1. Распространенность мутаций в генах факторов

V (G1691А - Leiden), II (G20210A) и МТГФР и риск кардиоэмболических нарушений мозгового кровообращения у больных с фибрилляцией предсердий.

5.2. Оценка значимости гипергомоцистеинемии как причинного фактора кардиоэмболических нарушений мозгового кровообращения у больных с фибрилляцией предсердий.

5.3. Приобретенные факторы риска тромбозов у больных с наличием и отсутствием ишемических кардиоэмболических нарушений мозгового кровообращения на фоне фибрилляции предсердий.

ГЛАВА

ФАКТОРЫ РИСКА ТРОМБОЗА СОСУДИСТОГО ДОСТУПА ПРИ ПРОВЕДЕНИИ ПРОГРАММНОГО ГЕМОДИАЛИЗА У БОЛЬНЫХ С ТЕРМИНАЛЬНОЙ ХРОНИЧЕСКОЙ ПОЧЕЧНОЙ

НЕДОСТАТОЧНОСТЬЮ

6.1. Особенности клинического статуса больных, находящихся на лечении программным гемодиализом и риск тромбозов сосудистого доступа.

6.2. Распространенность мутаций в генах факторов

V (G1691A - Leiden), II (G20210A) и МТГФР и риск тромбозов сосудистого доступа у больных, находящихся на лечении программным гемодиализом.

6.3. Оценка значимости гипергомоцистеинемии для риска тромбозов сосудистого доступа у больных, находящихся на лечении программным гемодиализом.

ГЛАВА

ЛЕЧЕНИЕ БОЛЬНЫХ С ВЕНОЗНЫМИ ТРОМБОЗАМИ: ЭФФЕКТИВНОСТЬ ВИТАМИННОЙ КОРРЕКЦИИ

ГИПЕРГОМОЦИСТЕИНЕМИИ И АНАЛИЗ ПРИЧИННЫХ ФАКТОРОВ, ПРОВОЦИРУЮЩИХ РЕЦИДИВ ВЕНОЗНЫХ ТРОМБОЗОВ ПОСЛЕ ЗАВЕРШЕНИЯ ЛЕЧЕНИЯ ВАРФАРИНОМ 7.1. Эффективность коррекции гипергомоцистеинемии и значимость мутаций в гене МТГФР для рецидивов гипергомоцистеинемии после завершения стандартного «стартового» 2-месячного курса витаминотерапии

7.2. Влияние мутаций в генах факторов V (G1691А - Leiden), II (G20210A) и МТГФР и гипергомоцистеинемии на вероятность рецидива венозных тромбозов в периоде после завершения терапии варфарином.

ГЛАВА

ЭФФЕКТИВНОСТЬ И БЕЗОПАСНОСТЬ АНТИКОАГУЛЯНТНОЙ ТЕРАПИИ ВАРФАРИНОМ. БЕЛОК-ПРЕДШЕСТВЕННИК ТРОМБА (ТрР) И ТЕСТ ГЕНЕРАЦИИ ТРОМБИНА КАК ПРЕДИКТОРЫ РЕЦИДИВА ВЕНОЗНЫХ ТРОМБОЗОВ В ПЕРИОДЕ ПОСЛЕ ЗАВЕРШЕНИЯ ТЕРАПИИ ВАРФАРИНОМ 8.1. Эффективность и безопасность одно- и трехлетней терапии варфарином у больных с венозными тромбозами.

8.2 Прогностическое значение определения уровня белка-предшественника тромба (ТрР) и данных теста генерации тромбина для оценки вероятности рецидива венозного тромбоза

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