Zimba O. Impact of the undifferentiated connective tissue dysplasia on development and clinical course of the rheumatism

Object: undifferentiated connective tissue dysplasia (UCTD) in patients with rheumatism; objective - to improve the diagnostics and prevention of rheumatism efficacy, to elaborate prognostic criteria of the severity of the disease based on the assessment of the influence of UCTD on the development and clinical course of the rheumatic process; methods- clinical, anthropometric, laboratory (values of the activity of the rheumatic process, immune system, endothelin-1); functional (EKG, Echo-KG, US of the abdominal organs, heart rhythm variability evaluation - HRV); statistical; result - the issue of the diagnostics and prevention of rheumatism efficacy improvement and elaboration of the prognostic criteria of the severity of the disease based on the assessment of the influence of UCTD on the development and clinical course of the rheumatic process were solved; novelty -for the first time the impact of the UCTD as the risk factor of rheumatism development was evidenced; it was established that the severity of the UCTD in patients with rheumatism correlate with the degree of the rheumatic process activity (C-reactive protein, seromucoids, proteinogram), with immune system changes (apoptosis incidence of the immune competent cells, T-cell immune deficit, activation of the humoral link of immunity, increase of the natural killers), with endothelial dysfunction marker (endothelin-1); for the first time it was noted that patients with rheumatism and severe degree of UCTD, multiple abnormal heart ventricular chords (AHVC) show reliable increase of the complicated rhythm disorders, than patients with mild degree of the UCTD and solitary AHVC; direct correlation was established between UCTD severity degree and probability of the valve disease development in patients with rheumatism; it was proved that the state of the vegetative nervous system in patients with rheumatism with severe and moderate degrees of UCTD shows decrease of the total HRV, parasympathic influences, increase of the sympathic link in comparison with patients with mild degree of the UCTD; for the first time the algorithm of the stratification of the risk of rheumatism development was elaborated; introduced into the practice of the number of treatment and preventive establishments of Ukraine and scientific, educational methodical process of three medical high educational establishments of Ukraine; filed -medicine.