Статьи журнала - Saratov Medical Journal
Все статьи: 102
Статья научная
The objective was to assess the effectiveness of the use of transcranial magnetic therapy in comprehensive non-drug recuperation of neonates with perinatal injury of the central nervous system. Materials and Methods. Our research involved 214 newborns with corrected age of 30 weeks of gestation and perinatal lesion of the central nervous system. Main group (n=79): neonates underwent standard pharmacotherapy in combination with comprehensive non-drug recuperation (which included dry immersion, music therapy and orolingual massage), and transcranial magnetic therapy. Comparison group (n=74): newborns underwent standard pharmacotherapy in combination with non-drug recuperation. Control group (n=61): infants received conventional pharmacotherapy. Results. In Main group, hyperexcitability syndrome was healed in 60% of infants, and autonomic visceral disorders were cured in 80% of children. CNS depression syndrome signs disappeared in 67% of neonates. A significant (p<0.05) decrease in the resistance index was noticed, along with reduction in elevated peripheral vascular resistance and expansion of physiological reflexes, especially of the oral automatism group. Odds ratio of normalization of oral reflexes by day 10 for Main group vs. Control group was 5.09 with 95% CI [1.8-13.8]; and for Main group vs. Comparison group, it was 3.0 with 95% CI [1.1-8.4]. Normalization of muscle tone and resistance index reduction by day 10 in Main group was observed 8 and 4 times more often, correspondingly, than in Control group. Odds ratios were 8.2 with 95% CI [1.8-16.3] and 4.05 with 95% CI [1.06-9.3], respectively. Conclusion. Non-drug recovery methods in combination with magnetic therapy generated the sedative effect; provided stimulation of respiratory movements and spontaneous motor activity; and contributed to restoring proper reflex action. Hence, they are recommended for inclusion in the perinatal CNS lesion therapy of neonates.
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Cognitive disorders in patients with chronic kidney disease in pre-dialysis period
Статья научная
Objective: to study the cognitive status of patients in the pre-dialysis period depending on the stage of chronic kidney disease (CKD) and the category of cardiovascular risk (CVR). Materials and Methods. We examined 98 patients with CKD in the pre-dialysis period (mean age 47.1±11.2 years). The patients were divided into three groups according to the criteria of CVR stratification. Group 1 consisted of 32 patients with a low or moderate CVR, and CKD stage C1 or C2; Group 2 included 34 patients with a high CVR and CKD stage C3a or C3b; Group 3 comprised 32 patients with a very high CVR and CKD stage C4. We used the SAGE test (Self-Administered Gerocognitive Examination) to evaluate cognitive functions. Results. Cognitive impairment (CI) was detected in 57% of the patients: 37.5% in Group 1, 44.1% in Group 2, and 90.5% in Group 3. Dementia was diagnosed in 19% of patients with CI. A correlation was found between the severity of CI, the degree of decrease in glomerular filtration rate, and the education level of CKD patients in the pre-dialysis period (p≤0.001). We established that the examined subjects with CKD were characterized by memory, constructive, spatial and logical thinking disorders. Conclusion. Chronic kidney disease is an independent risk factor for the development of CI. The latter progressed with both CKD stage and the patient’s CVR category, and was detected in 37.5% of patients with a low or moderate CVR, 44.1% of patients with a high CVR, and 90.5% of patients with a very high CVR.
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Comparative analysis of surgical plasty of bone defects in distal humerus fractures
Статья научная
Objective: to conduct a comparative analysis of the plastic surgery outcomes of bone defects in various locations in distal humerus fractures using block and cancellous allografts. Materials and methods. The study included 56 patients with comminuted fractures of the distal humerus distributed among 3 groups depending on the bone defect location and 2 subgroups based on the bone grafting. Elbow joint function was assessed using the Broberg and Morrey rating system, pain syndrome was evaluated according to the visual analog scale. Results. The amplitude of flexion and extension movements of the elbow joint in medial area defects 1.5 months after plastic surgery with a block allograft reached 90±5º (p=0.04) and 75±6º when using cancellous allograft. Three months after surgical repair with a block allograft, the strength and pain scores for defects reached 80±2 pts in the central area, 82±3 pts in the lateral area and 88±4 pts in the medial column. For cancellous allograft, these scores were 59±5 pts (p=0.01), 62±3 pts (p=0.01) and 60±3 pts (p=0.03), respectively. Conclusion. The plasty of the bone defect with a block allograft for distal humerus fractures contributes to an increase in the multiplanar range of motion 1.5 months after surgery for a medial column defect, and also improves strength and increases range of the flexion and extension motion, and reduces pain 3 months after surgery for defects of the medial, lateral and central metaphyseal locations.
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Статья научная
The objective of our study was to investigate the features of circulatory autonomic regulation in the patients with a coronary artery bypass graft surgery (CABG) or correction of a valvular heart disease (CVHD). Material and Methods. Our study enrolled 42 patients (including 12 women) aged 63 (57; 67), who underwent CABG; and 36 patients (including 16 women) aged 58 (47; 65), who underwent CVHD. Simultaneous 15-minute recordings of electrocardiograms and photoplethysmograms (PPG) were performed on all patients before and after the surgery. We assessed and analyzed statistical and frequency-related measures of heart rate variability (HRV) and index of synchronization (S) among low-frequency (LF) oscillations in HRV and PPG. Results. The values of most autonomic regulation indices in our study did not have statistically significant differences among the patients with CABG and CVHD at all stages of research. The exception was represented by the heart rate, which was higher before CVHD (p=0.013). Conclusion. In all patients with CABG, the values of HRV and S did not depend on the differences in their clinical statuses or performed cardiac surgical interventions.
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Comparative efficiency of various molecular genetic methods in diagnosing tuberculosis
Статья научная
Objective – to compare the efficacy of various molecular genetic methods for diagnosing tuberculosis and determining drug susceptibility to rifampicin (RIF). Materials and Methods. We conducted a retrospective study of the sputum analysis results on 1,992 patients with pulmonary tuberculosis treated at Saratov Oblast Clinical Tuberculosis (TB) Dispensary from 2014 through 2018. The following methods were used: real-time polymerase chain reaction (PCR), biological microarrays, automated Xpert® MTB/RIF technology. Statistical processing of the research results was carried out using the Bayes formula based on contingency tables (four-field table) and the χ2 test. When evaluating the significance of differences between relative values, we employed the critical significance level of 0.05. Results. In terms of etiological diagnosis of TB, higher diagnostic sensitivities of the real-time PCR and biological microarray methods (73.9% and 70.3%, correspondingly) were established, as compared with the Xpert® MTB/RIF method (34.2%) (p<0.001). The sensitivity of all methods depended on the massiveness of bacterial excretion and clinical form of TB. Conclusions: The Xpert MTB/RIF method exhibited lower diagnostic sensitivity in verifying the diagnosis of TB, whereas its operational characteristics in terms of determining RIF-resistance were sufficiently high (sensitivity at 89.7%, specificity at 89.1%, and efficacy at 89.4%), which was comparable with the characteristics of biological microarray method (93.9%, 71.8%, 82.9%; p=0.127, p<0.001, p=0.139, respectively).
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Comparative evaluation of bone defect replacement methods in revision total knee arthroplasty
Статья научная
Objective: to evaluate the immediate and long-term outcomes of revision total knee arthroplasty using porous metaphyseal sleeves and cones. Materials and Methods. The study included 134 patients who underwent revision total knee arthroplasty. The patients were distributed among two groups based on the type of metaphyseal fixator: sleeves (Group I, n=97 patients) and cones (Group II, n=37 patients). Surgical outcomes were assessed upon discharge from the hospital (after the hospital stay of 7-12 days), as well as after 6, 12 and 24 months after surgery. The survival rate of endoprostheses was analyzed using the Kaplan–Meier method. A revision with total replacement of the endoprosthesis or its components was considered a critical event. Results. The analysis of the survival rate of endoprostheses in the form of various metaphyseal fixators showed that the groups of sleeves and cones did not differ statistically significantly as suggested by the logrank test (Mantel–Cox): p=0.108. Conclusion. The midterm follow-up revealed no difference in clinical, functional, or radiological outcomes of revision total knee arthroplasty performed for types 2A, 2B, and 3 of bone defect replacement (sensu Anderson Orthopaedic Research Institute classification) using trabecular metal metaphyseal cones vs. sleeves.
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Статья научная
Objective: to evaluate the hospital outcomes of coronary artery bypass grafting using autoarterial and autovenous conduits. Materials and Methods. We conducted a randomized clinical trial. We used the left internal thoracic artery for bypassing the anterior interventricular branch in both groups. The remaining conduits were either only the radial artery or the radial artery and great saphenous vein (study group) or solely the great saphenous vein (control group). The investigated outcomes were, among others, in-hospital mortality, Type 5 myocardial infarction, cerebrovascular event, respiratory failure, bleeding, cardiac arrhythmias, and acute kidney injury (AKI). Results. A sample of 27 patients was randomly distributed among the study group (n=12) and the control group (n=15). According to the perioperative and early postoperative data, there were no statistically significant differences between the groups, except for the duration of stay on artificial ventilation in intensive care unit: in the study group, it was longer than in the control group: 14 (12; 18) h versus 9.3 (5.8; 13) h, p=0.034. The most common complications were cardiac arrhythmias and AKI. There were no statistically significant differences between groups regarding studied for outcomes. Postoperative hospital stay (expressed as number of bed days) also did not differ statistically significantly between groups. Conclusion. According to our data, in the first days after surgery, the use of the radial artery does not provide significant advantages compared to the use of the great saphenous vein.
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Статья научная
Objective: to identify the proportion of complications after suburethral implantation of polypropylene slings in women with stress urinary incontinence based on a seven-year experience. Material and Methods. We conducted the analysis of а seven-year experience in various implantation techniques of suburethral slings in 1260 women with stress urinary incontinence: inside-out and outside-in obturator sling fixation; suprapubic sling fixation and non-trocar mini-sling installment. Results. The highest incidence of complications was observed over the first two years after suburethral sling implantation was performed. Subsequently, the proportion of complications declined progressively to the lower limit values of 7-8% in the course of three last years. An incidence of early surgical complications among various suburethral sling implantation techniques had no statistically significant differences. However, after the suprapubic sling implantation, intraoperative and mesh-associated complications prevailed. Conclusion. Our study confirmed that suburethral sling implantation using suprapubic fixation method was associated with a higher incidence of complications and should have been performed exclusively for the target group of the patients, for whom safer surgical procedures were contraindicated.
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Culinary medicine as an integrative field of modern healthcare: A review
Статья научная
This article examines culinary medicine as a developing integrative field in modern healthcare, combining evidence-based medicine, nutritional science, and clinical dietetics. The relevance of this topic is determined by the global rise in diet-related chronic diseases and the need for effective preventive programs aimed at fostering a healthy eating culture. The paper explores the theoretical foundations of culinary medicine, its differences from related disciplines such as dietetics and nutritional science, and highlights the interdisciplinary collaboration of physicians and chefs in developing therapeutic diets. Particular attention is given to international studies demonstrating the integration of culinary medicine courses into medical education in the United States and Europe, which has significantly improved the competence of future physicians in nutrition counseling. The paper emphasizes the need to implement similar educational and clinical practices in Russia to support disease prevention and promote responsible eating behavior. Culinary medicine is presented as a promising tool for the formation of an integrative healthcare model aimed at improving public health and quality of life.
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Статья научная
Objective: development of the technology of immediate sequential bilateral cataract surgery (ISВCS) and assessment of its clinical effectiveness. Materials and Methods. Our study was conducted in two stages. At stage I, we reviewed the published materials on traditional algorithm of conducting ISВCS, as a result of which, a modified algorithm for performing surgical intervention (mоISBCS) was developed. At stage II, 130 patients (mean age of 58.4±1.8 years) with uncomplicated binocular cataract were under observation. Patients were divided into two groups of similar age and eye condition. The main group included 67 people (134 eyes), who underwent mоISBCS. The control group comprised 63 subjects (126 eyes), who underwent surgery on the second eye (delayed sequential bilateral cataract surgery, DSВCS) 21–28 days after the first operation. Results. The analysis of traditional provisions served the basis for improving ISВCS technology by including a long (at least 60 min) pause between operations with a comprehensive examination of the patient in the algorithm of surgical intervention. The obtained data demonstrated similar clinical effectiveness of mоISBCS and DSВCS. Conclusion. The mоISBCS technology can be considered an effective and safe method of cataract surgical treatment, which is especially important for patients with occupation yielding a visual stress.
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Статья научная
Objective: to develop a simple and user-friendly technology for the detection of DNA targets for the diagnosis of socially significant diseases based on a colorimetric aggregation assay using gold nanoparticles. Materials and Methods: Gold nanospheres were synthesized by liquid-phase chemistry methods. The physicochemical parameters of the nanoparticles were controlled using absorption spectroscopy, dynamic light scattering, and electron microscopy. Rational design of specific genomic target sequences and oligonucleotides included in the test system was carried out considering thermodynamic constants and using genomic databases. Analytical validation of the test system was performed using a model for the detection of Babesia species DNA — the causative agent of piroplasmosis in humans and animals — by cross-comparison of characteristics with polymerase chain reaction (PCR) with electrophoretic detection in real-time format. Results: A pilot version of the test system for specific detection of up to 10 ng of DNA in blood samples was developed, based on visual discrimination of the color of the reaction mixture with an analysis duration of approximately 30 minutes. The size effect of nanoparticles in the range from 15 to 60 nm on the minimum detection limit of DNA targets was established. Conclusion: This study presents the results of the development and analytical validation of a pilot express test system for DNA diagnostics based on gold nanoparticle labeling and visual color discrimination of the reaction mixture.
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Статья научная
Objective: to perform a comparative analysis of heart rate (HR) spectral indices during the six-minute walk test (6MWT), considering β-blocker intake, and to determine parameters capable of characterizing cardiac contractility and chamber dimensions in chronic heart failure (CHF). Materials and Methods. The study involved patients with stable CHF of either ischemic or hypertensive etiology: those receiving β-blockers (the main group) and those who had refrained from β-blocker use for over one month before undergoing the 6MWT (the control group). All participants completed Doppler echocardiography and the 6MWT. Spectral indices of HR within the frequency range [0; 1] Hz were measured at every stage of the 6MWT. Evaluated parameters included the ratio of predominant frequencies in the spectrum for stages II vs. I (fII/I), stages II vs. IV (fII/IV) of the 6MWT, and mean HR recovery time. Results. No statistically significant correlations were identified between HR frequency composition ratios, Doppler echocardiography metrics, and the NYHA class of CHF in the main group. However, in the control group, a larger left ventricular ejection fraction correlated positively with increased fII/I ratios and reduced HR recovery times. Conclusion. The spectral characteristics of HR during the 6MWT could serve as markers of compliance with β-blocker treatment and might indirectly indicate cardiac contractility and chamber size in CHF patients not currently using β-blockers.
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Статья научная
Objective: to assess the dynamic of motor imagery skill formation while using brain-computer interface (BCI) with visual and vibrotactile biofeedback. Material and methods. The pilot study included 10 healthy volunteers aged 29–34 years. All participants were right-handed. Over a five-day protocol, two feedback modalities were employed: visual and vibrotactile. Detection of motor imagery events occurred in real-time using a classifier based on the analysis of electroencephalographic (EEG) activity patterns. The accuracy (proportion) of recognizing motor imagery for both the left and right hands was evaluated across five experimental sessions. Results. It was demonstrated that learning followed a U-shaped trajectory: following an initial decline in recognition rates during the midpoint of the training sessions (dropping from baseline levels of 76% and 80% to 66% and 71% for the right and left hands, respectively), there was significant improvement by the fourth or fifth session, achieving peak values throughout the experiment (approximately 85% and 90%, respectively). This indicated the establishment of stable neural representations. Conclusion. Acquisition of motor imagery skills through a brain-computer interface incorporating visual and vibrotactile feedback exhibits a U-shaped learning curve, culminating at its highest point on the fifth day of training.
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Статья научная
Objective: to study the effect of different pancreatic stump closure techniques and diameter of the main pancreatic duct on frequency and severity of acute postoperative pancreatitis after distal pancreatectomy. Material and Methods. Distal pancreatectomy was performed on 126 patients with neoplasms of body and/or tail of the pancreas. Patients were distributed among four groups based upon the pancreatic stump closure technique applied after distal pancreatectomy: group 1 (control) included the patients with isolated suturing of the main pancreatic duct in the pancreatic stump with its subsequent sealing by the gastrocolic omentum or hemostatic sponge; group 2 patients underwent isolated suturing of the main pancreatic duct in the pancreatic stump with its subsequent sealing with 2-octyl cyanoacrylate biological glue; group 3 patients had their pancreatic stump closure performed with endoscopic linear cutter stapler; group 4 was composed of the patients with external transduodenal transnasal drainage of enlarged (D>3 mm) main pancreatic duct in the pancreatic stump. Results. The occurrence of acute postoperative pancreatitis in the control group amounted to 45.8%, while, in groups 2, 3 and 4, the frequencies were 44.4, 9.7 and 15.0(%), correspondingly. Besides, the control group was characterized by declined occurrence of the moderately severe form of acute postoperative pancreatitis. Use of endoscopic linear cutter stapler and external transduodenal transnasal drainage of the enlarged main pancreatic duct caused lower acute postoperative pancreatitis frequency in the patients with main pancreatic duct in their pancreatic stumps below 5 mm in diameter. Conclusion. Use of proposed pancreatic stump closure techniques after distal pancreatectomy resulted in lower frequencies of occurrence and severity of acute postoperative pancreatitis.
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Objective: to compare the condition of periodontium in three categories of patients: smokers of electronic cigarettes (EC), smokers of heated tobacco products (HTP) and nonsmokers vs, their age and gender. Materials and Methods. We carried out a comprehensive analysis of 1,754 patient records including EC smokers (n=1,122) and HTP smokers (n=632).Data from 566 nonsmokers were used as a comparison group (CG). Patients of all groups were distributed among subgroups depending on their age and gender. The clinical condition of the periodontium was assessed using dental indices and indicators. For statistical data analysis, we employed Microsoft Excel and STATISTICA 64 version 20.0 software. Results. Gingivitis prevailed in all three groups. Itsprevalence in EC smokers decreasedwith age; the opposite trend was observed in HTP smokers. As for CG, gingivitis was recorded in all age groups. The prevalence of acute periodontitis was the highest in EС and HTP smokers aged 35-39 years vs. 30–34-year-old individuals of the CG. In HTP and EC smokers, the prevalence of gingivitis and acute periodontitis was more pronounced in females, while we observed no statistically significant difference of the kind between men and women of the CG. The frequency of occurrence of localized chronic periodontitis was maximum in EC and HTP smokers at the age of 40–44 years vs. 45–50 years in the CG subjects. However, in the HTPGroup, it was more pronounced in females, while in the EC Group it was more characteristic in males. The frequency of occurrence of generalized chronic periodontitis in individuals of all groups was more pronounced in women. Conclusion. The results of our study confirmed that the use of EC and HTP is a harmful factor causing the occurrence of periodontal disease.
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The objective was to study the dose-dependent effects of glucagon-like peptide-1 receptor agonist, liraglutide, on microcirculation in white rats under the alloxan-induced insulin deficiency. Materials and Methods. Our study was carried out on 70 white rats, divided into four groups: 20 intact control animals; 20 animals of the comparison group with alloxan-induced diabetes; 10 animals with insulin deficiency, injected with liraglutide at a dose of 0.2 mg/kg per day (treatment group No. 1); and 20 animals with insulin deficiency treated with liraglutide at a dose of 0.4 mg/kg per day (treatment group No. 2). Diabetic status, skin perfusion of the posterior limb and mechanisms of blood flow modulation were assessed in all groups of animals. Results. It was established that administering liraglutide at a dose of 0.4 mg/kg per day allowed achieving complete normalization of carbohydrate metabolism in rats with alloxan-induced insulin deficiency, thereby more effectively improving the state of microcirculation, compared with a dose of 0.2 mg/kg per day. Conclusion. The efficacy of correcting the microcirculatory disorders with liraglutide correlates with correcting the carbohydrate metabolism in rats with insulin deficiency and depends on liraglutide dose. The dose-dependent effect is achieved by the endothelial mechanism of flow modulation in microcirculation. However, the restoration of the vascular tone neurogenic component is independent of liraglutide dose.
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Objective: To evaluate the effect of metronidazole loaded into alginate microcapsules impregnated with silver on structural and functional periodontium disorders in periodontitis. Materials and Methods. Our research was conducted on 30 white male rats, randomly distributed among two groups. The comparison group consisted of 15 animals with experimental periodontitis, which received applications of a gel containing microcapsules without additional loading of active substances. The experimental group included 15 animals with periodontitis, which received applications of gel with microcapsules containing metronidazole to the inflamed gums. To assess the morphological changes in periodontium, the mandible was collected followed by its histological examination. Results. Application of a gel containing microcapsules with silver nanoparticles loaded with metronidazole on the gums of animals with periodontitis led to a partial reduction of structural disorders. E.g., out of 15 animals, local disorganization of the periodontal ligament fibers in the experimental group was observed only in 5 cases and signs of limited bone loss were observed in 2 cases. In the comparison group, bone resorption was noted in all 15 animals, while diffuse alteration of fibers throughout the periodontal ligament was confirmed in 13 of 15 cases. Conclusion.The inclusion of metronidazole in alginate microcapsules with silver nanoparticles leads to a significant reduction in the destructive processes occurring in the periodontal tissues during periodontitis.
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Objective: to assess the impact of the remote monitoring system on the lipid profile after myocardial infarction (MI) in urban and rural areas of the Perm Krai. Materials and Methods. Our study conducted from 2020 through 2022 included 253 patients diagnosed with MI. The study compared two groups of patients: those who did not participate (n=105) and those who participated in the Remote Health Monitoring of Patients with Cardiovascular Diseases (RM) program (n=148). RM of patients was carried out at least once a month by telephone calls using an approved list of questions. Results. The group of patients participating in the RM system exhibited a significant improvement in the lipid profile vs. groups of patients not participating in the RM program. The total cholesterol levels in the RM groups of Perm Krai and city of Perm were 3.77 and 4.30 mmol/L, respectively, vs. 5.50 and 4.50 mmol/L in the rural and urban groups without RM. Statistically significant differences between the groups were observed only in Perm Krai (p=0.002). The low-density lipoprotein (LDL) level in patients with RM was 1.77 mmol/L in Perm Krai and 2.31 mmol/L in the city of Perm vs. 3.24 and 2.67 mmol/L in the rural and urban groups without RM (p=0.049 and p=0.025), respectively). Patients in the RM group from Perm Krai were 15.6 times more likely to achieve target LDL values than their counterparts without RM. Conclusion. The RM system had a favorable effect on reducing LDL and cholesterol in both urban and rural groups of residents.
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Objective: to analyze the features of clinical course of lower limb varicose vein disease and acute thrombophlebitis of varicose veins for the patients with undifferentiated connective tissue dysplasia (UCTD) after crossectomy. Materials and Methods. The prospective clinical cohort study involved 132 female patients with varicose disease who underwent crossectomy, of which 67 patients with dysplasia were included into the main group, whereas patients without dysplasia were included into the control group. Examination of patients and ultrasound scanning of leg veins were conducted in 3, 6, 12, and 36 months. The Cox regression analysis was used to assess the effect of dysplasia on the risk of developing thrombophlebitis of varicose veins. Results. The progress of varicose disease clinical manifestations of after crossectomy was detected in 57 (85.1%) female patients with dysplasia and in 14 (21.5%) without it (р=0.002), which resulted in phlebectomy. The recurrent thrombophlebitis of varicose veins was found in 22 (32.8%) female patients with dysplasia vs. 5 (7.7%) without it (р=0.002). Cox regression model Exp (B), which characterizes the predicted change of risks for dysplasia, was 4.216 (95% CI 1.595-11.147). Conclusion. The clinical course of varicose disease in patients with UCTD is characterized by the progression of clinical manifestations of chronic venous insufficiency of a lower limb. UCTD results in over 4.2-fold risk of developing the recurrent thrombophlebitis of varicose veins after crossectomy.
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Objective: to reveal the dependence of the efficiency of platelet (PL) aggregation on crosstalk between signaling pathways associated with stimulation of the thromboxane receptor (TxR) and purine P2 receptors at different activity of cyclooxygenase (COX) during the administration of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with nephrolithiasis (NLT). Materials and Methods. Our study was prospective in its nature. It included 60 patients with NLT who were prescribed non-selective NSAIDs as part of medical expulsive therapy (MET) for analgesia. The cohort of patients was distributed among two groups: with effective (Group 1, n=30) and ineffective (Group 2, n=30) COX inhibition. The activity of the TxR and purine P2 receptors (P2X1 and P2Y receptors) of PL was assessed on a Chrono-Log Hematology Analyzer (USA). Agonists (adenosine triphosphate, adenosine diphosphate and arachidonic acid) were used at EC50 and EC10 concentrations. Results. In Group 1, after 72 hours of MET, the activity of the TxR and P2 receptors of PL decreased to the level of hyporeactivity. Regulation of the compensatory response of PL to hematuria was ensured through the synergism of P2X1 and P2Y receptors, TxR, and P2X1 receptors. In Group 2, after 72 hours of MET, the hyperreactivity of the TxR and P2 receptors persisted. The maximum increase in PL aggregation was achieved with synergism between the TxR and P2Y receptors. Conclusion. The effectiveness of PL aggregation in hematuria of patients with NLT during the administration of NSAIDs is determined by intracellular signaling associated with the TxR and P2 receptors.
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