ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2025-1-96-104ssmu-5968Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSАнализ взаимосвязи маркеров низкоинтенсивного воспаления с выраженностью атеросклеротического поражения коронарного руслаAnalysis of the relationship between low-grade inflammation markers and the severity of atherosclerotic coronary bed lesionshttps://orcid.org/0000-0002-7020-4442УшаковА. В.UshakovA. V.

Ушаков Алексей Витальевич – д-р мед. наук, профессор, зав. кафедрой внутренней медицины № 1 

295051, г. Симферополь, бульвар Ленина, 5/7

5/7, Lenin Blvd., Simferopol, 295051

ushakovav88@mail.ruhttps://orcid.org/0000-0002-7384-9705ЗахарьянЕ. А.ZakharyanE. A.

Захарьян Елена Аркадьевна – канд. мед. наук, доцент кафедры внутренней медицины № 1 

295051, г. Симферополь, бульвар Ленина, 5/7

5/7, Lenin Blvd., Simferopol, 295051

locren@yandex.ruhttps://orcid.org/0000-0001-7390-9109ГригорьевП. Е.GrigorievP. E.

Григорьев Павел Евгеньевич – д-р биол. наук, доцент, профессор кафедры «Психология»; вед. науч. сотрудник 

299053, г. Севастополь, ул. Университетская, 33;298603, г. Ялта, ул. Мухина, 10/3

33 Universitetskaya Str., Sevastopol, 299053;10/3, Mukhina Str., Yalta, 298603

mhnty@ya.ruhttps://orcid.org/0000-0002-6591-2719МалыйК. Д.MalyiK. D.

Малый Константин Дмитриевич – канд. мед. наук, доцент кафедры биохимии 

295051, г. Симферополь, бульвар Ленина, 5/7

5/7, Lenin Blvd., Simferopol, 295051

kdmalykd@gmail.comОрдена Трудового Красного Знамени Медицинский институт им. С.И. Георгиевского, Крымский федеральный университет им. В.И. Вернадского (МИ КФУ)РоссияThe Order of the Red Banner of Labour Medical Institute named after S.I. Georgievsky of the V.I. Vernadsky Crimean Federal University (MI CFU)Russian FederationСевастопольский государственный университет (СевГУ); Академический научно-исследовательский институт физических методов лечения, медицинской климатологии и реабилитации им. И.М. Сеченова (АНИИ им. И.М.Сеченова)РоссияSevastopol State University (SevSU); Academic Scientific Research Institute of Physical Methods of Treatment, Medical Climatology and Rehabilitation named after I.M.Sechenov (Sechenov ASRI)Russian Federation20251604202524196104Copyright © Ушаков А.В., Захарьян Е.А., Григорьев П.Е., Малый К.Д., 20252025Ушаков А.В., Захарьян Е.А., Григорьев П.Е., Малый К.Д.Ushakov A.V., Zakharyan E.A., Grigoriev P.E., Malyi K.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/5968

Цель. Изучение сывороточных концентраций маркеров низкоинтенсивного воспаления у пациентов с ишемической болезнью сердца (ИБС) в контексте их клинико-инструментальных характеристик, а также оценка их предиктивной ценности в выраженности атеросклеротических процессов коронарного русла. Материалы и методы. В исследование включены 264 человека (161 мужчина и 103 женщины), из них 220 – пациенты с диагнозом ИБС. Среди пациентов были выделены подгруппы с наличием инфаркта миокарда в анамнезе (110 человек) и стенокардией (152 человека). Группа контроля представлена здоровыми добровольцами (44 человека). Пациентам выполнены коронароангиография; эхокардиографическое исследование; дуплексное ультразвуковое сканирование внечерепных отделов брахиоцефальных артерий. Проведено исследование уровня С-реактивного белка (СРБ, мг/л), фактора некроза опухоли альфа (ФНО-α, пг/мл), фактора дифференцировки роста 15 (GDF-15, пг/мл) и специфической молекулы эндотелиальных клеток-1 (ESM-1, нг/мл) в сыворотке крови. Статистически значимыми считали различия при р < 0,05. Результаты. Выявлена значимо большая концентрация всех лабораторных маркеров субклинического воспаления в группе пациентов с ИБС в сравнении с контролем, а также значимое повышение их значений по мере увеличения выраженности коронарного атеросклероза (p < 0,0001). Показана статистическая значимость различий уровня маркеров между группами пациентов с наличием стенокардии и инфаркта миокарда в анамнезе в сравнении с пациентами без данных признаков. Выявлена корреляционная связь разной силы и значимости между значением маркеров и рядом клинико-инструментальных характеристик пациентов. При проведении линейного многофакторного регрессионного анализа выявлена статистически значимая связь баллов по шкале SYNTAX с концентрацией GDF-15 и ESM-1 при отсутствии таковой с СРБ и ФНО-α. Заключение. Одновременное количественное определение нескольких лабораторных показателей может быть более мощным инструментом для оценки риска прогрессирования ИБС. Показано, что эндокан и GDF-15 имеют высокую предиктивную значимость в оценке выраженности атеросклеротических процессов в коронарных артериях.

Aim. To study serum concentrations of low-grade inflammation markers and the severity of atherosclerotic processes in the coronary artery in patients with coronary heart disease (CHD) in the context of their clinical and instrumental characteristics. Materials and methods. The study included 264 participants (161 men and 103 women), with 220 of them being diagnosed with CHD. Subgroups were identified among the participants, including those with a history of myocardial infarction (110 patients) and angina pectoris (152 patients). A control group consisted of healthy volunteers (44 persons). The patients underwent coronary angiography, echocardiography, duplex ultrasound scanning of the extracranial segments of the brachiocephalic arteries. The level of C-reactive protein (CRP (mg/L)), tumor necrosis factor alpha (TNF-α (pg/ml)), growth differentiation factor 15 (GDF-15 (pg/ml)), and endothelial cell specific molecule-1 (ESM-1 (ng/ml)) in the blood serum were measured. Statistical significance was considered at p < 0.05. Results. A significantly higher concentration of all laboratory markers of low-grade inflammation in the CHD group of patients compared to the control group, as well as a significant increase in their values with enhance in the severity of coronary atherosclerosis (p<0.0001) was found. Significant differences in marker levels were also found between patients with angina pectoris and a history of myocardial infarction compared to those without these conditions. A correlation was revealed between the value of markers and various clinical and instrumental characteristics of the patients. Multivariate linear regression analysis revealed a statistically significant association of SYNTAX score with the concentration of GDF-15 and ESM-1, but not with CRP and TNF-α. Conclusions. The simultaneous measurement of multiple laboratory parameters may be a more effective method for assessing the risk of CHD progression. The study also showed that endocan and GDF-15 have high prognostic significance in evaluating the severity of atherosclerotic processes in the coronary arteries.

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The authors declare that there are no conflicts of interest present.