Sonina H. Clinico-pathogenetic peculiarities in myocardial infarction on the background of type 2 diabetes mellitus, rational approach to the treatment and medical rehabilitation

The work deals with the clinico-pathogenetic peculiarities of myocardial infarction (MI) at its subacute stage on the background of type 2 diabetes mellitus (DM) as well as the study of the peculiarities of carbohydrate, lipid metabolism, the processes of lipid peroxidation and antioxidant protection, functional miocardial changes depending on the method of medical rehabilitation of the patients with this disease. The use of omega-3 polyunsaturated fatty acids of epadol on the background of basic therapy in the dosage of 2 g in 24 hours for 8 weeks in the period of early rehabilitation of the patients who sustained myocardial infarction on the background of type 2 diabetes mellitus and who had liver steatosis manifestation (69,8%), resulted in the decrease in algesic attacks by 2,4 time, the decrease in heart failure manifestation in 45,3% cases, the positive dynamics of blood pressure indices in 79,2% cases, the decrease in frequency of decompensation DM manifestation by 2,9 times. The decrease of thelevel of glycemia indices by 24,1%, glicosylized haemoglobin by 20,3%, general cholesterol by 1,2 times, lipoproteins of very low density by 1,5 times, triglycerides by 1,6 times, atherogenic index by 1,4 times and the elimination of serum aminotransferase activity in most cases of disease have been attained. The decrease of concentration of lipoperoxidation products - dienic conjugates by 1,6 times, malon dealdegid by 1,4 times, as well as the increase in the activity of the ferments of the system of antioxidant protection - catalasa by 1,2 times, superoxiddismutase by 1,4 times, integral index F by 1,6 times have been proved. The improvement of the output fraction and restoration of sinus rhythm in 79,2% cases of disease howe been attained.