Sazonenko L. An improvement in therapy for preeclampsia based on correction of pathogenetic changes in the L-arginine-NO system.

The thesis is devoted to the problem of therapy for preeclampsia in pregnants with an account for possible usage of drugs, which are donators of L-arginine and NO, on the basis of studying and correcting changes in the L-arginine-NO system. Relevant clinical-paraclinical findings were studied as well as peculiar features of the L-arginine-NO sys-tem, immune system, and blood fatty-acid spectrum in pregnant women with preeclampsia of various severity degrees. Based on the results obtained, schemes of combined therapy for preeclampsia were developed using Cardiket, a NO donator, and Citrarginine, a L-arginine donator. A comparative analysis between the therapeutic methods proposed and the traditional method showed higher efficacy of the formers. In addition, criteria were de-veloped for the evaluation of therapy efficacy in pregnant women with preeclampsia. The use of Cardiket allowed for restoration of the L-arginine-NO system, immune system, lipid metabolism, hepatic and renal functions, and had pronounced clinical effects, especially in relation to hypertension component, facilitated a 2.5-fold lowered rate of preterm delivery as well as a 2.3-fold lowered incidence of fetal hypoxia and hypotrophy, 1.8-fold lowered frequency of complicated running of delivery, and 5-fold lowered inci-dence of hypotonic bleedings as compared with the traditional therapy. The use of Citrarginine facilitated the normalization of parameters of the L-arginine-NO system, immune system, lipid metabolism, hepatic and renal functions, and had pro-nounced clinical effects, especially in relation to edematous component and/or proteinuria. It allowed for a 5-fold lowered rate of preterm delivery, 3-fold lowered incidence of fetal hypoxia and hypotrophy, 2.8-fold lowered frequency of complicated running of delivery, 5-fold lowered incidence of hypotonic bleedings as compared with the traditional therapy.