Leontyeva S. Clinical and pathogenetical peculiarities of the secondary Raynaud's syndrome and their medicamentous corrections

The object of the research is patients with secondary Raunaud's phenomen (RP). The aim is to find out clinical and pathogenetical peculiaries of the secondary RP of various levels of complexity, and to develop algorithms of its diagnostics to increates the effectioness of treatment with the usage of the angiotensin II receptor antagonists candesartan. Methods - clinical, laboratory, instrumental, morphological and statistical. While testing 120 patients with the secondary RP, the superiority of factors of humoral regulation of the vessel tonus of vasoconstrictor influence, such as endothelin-1 (ET-1) and angiotensin II (AT II), the increase of the level of antinuclear factor (ANF) was established in proportion to the level of complexity of existing pathology and also the presence of increased coefficient asymmetry (CA) in case of light level of complexity of the secondary RP and changes of rheosystolical index (RSI) and complex "intima-media" (CIM). The applied by us pathogetical correction of the secondary RP by candesartan had positive effect, first of all, on the state of vessels of upper limbs in all clinical forms of complexity. In mild and average level of secondary RP a considerable vasodelatation was achieved due to the decrease of the ET-1 level with the simultaneous increase of 6-keto-prostaglandin F1а (6-keto-PG F1а), which improved the circulation of blood in vessels. The severe case of the secondary RP was indicated by considerable structural changes of vessel-bed, but in the process of treatment delatation , decrease of ANF and pulsative index (PI) was indicated. Indicated above positive changes were confirmed by the data received from the patient's questioner, that is the descrease of the level of painful feelings in the case of average and severe degrees of course according to visual - analogue scale and the index of the duration of attacks in the case of severe degree of course of the secondary RP. The results of the research have been introduced into medical institutions, scientific and educational process. The field is medicine.