The dissertation work was aimed at improving the diagnostic criteria for the severity of damage to the arterial vessels in patients with acute pulmonary embolism (РЕ) and chronic thromboembolic pulmonary hypertension (СhТРН) and to evaluate the effectiveness of treatment with their help. According to the aim and objectives of the study, we have examined 110 patients with a suspicion for PE at the age group of 35 to 90 years (64,2 ± 14,4), including 66 women (60 %) and 44 men (40 %). Of the 110 patients examined in 94 (85,5 %), a diagnosis of pulmonary embolism was established. Pulmonary embolism was the most frequently determined in the elderly group of patients, namely, at the age of 70 - 79 years (26,5 %), and in women (61 %). According to computer tomography angiopneumography (CTAPG), from 94 patients in the main group, 68 (72,3 %) patients had a diagnosis of acute PE, and 26 (27,7 %) had the signs of thromboembolic pulmonary hypertension (ChTPH). Using complex CTAPG, the diagnostic criteria for acute pulmonary embolism and ChTLG were clarified and supplemented. CTAPG-diagnosis of pulmonary complications associated with these conditions was performed. During the work on the dissertation, we have developed and calculated the extent of damage of the arterial bed (EDAB) of the lungs, which consists of the sum of arterial (maximum - 18 points) and perfusion (maximum - 18 points) indexes, is developed. The degrees of severity of pulmonary thromboembolism from I (light) to IV (extremely severe) are determined. According to our classification, all the patients were divided into three groups: 57,5 % (54 patients) had 3d degree of the disease severity (severe), EDAB index was 24,4 ± 1,7 points, the ventricular index was 2,3 ± 1,01 points, the size of the right (RV) and left ventricles (LV) is 50,1 ± 5.3 mm and 24,0 ± 6.5 mm respectively; in 30 of them (31,9 %), the severity of the disease (average) was found to be 2, the EDAB index was 18,8 ± 1,9 points, the ventricular index was 0,97 ± 0,04 points, the size of the RV and the LV was 41,9 ± 4,9 mm and 43,1 ± ± 4,2 mm respectively; 1 degree of PE severity (mild) was determinedin 10 patients (10,6 %), EDAB index - 14,5 ± 1,6 points, the ventricular index - 0,9 ± 0,5 points, the size of the RV and the LV - 38,7 ± 4,1 mm and 42,2 ± 3,8 mm respectively. The correlation analysis data show a strong positive correlation between EDAB and ventricular index - r = 0,609, p < 0,001. In the course of treatment, CTAPG was repeated to 36 patients (38,3 %), of which 27 (75,0 %) had signs of acute pulmonary embolism and 9 (25,0 %) - ChTPH. The median EDAB index for all the patients (n = 36) before treatment was 21,8 ± 3,9, and after treatment it decreased to 7,4 ± 6.4 (p < 0.05), that is, the extent of arterial bed deficiency decreased by almost 3 times. The changes of EDAB during treatment has been analyzed, the convenience and ease of use of this index for assessing the effectiveness of therapy has been confirmed. Significant decrease of the EDAB index was observed in patients with acute PE and СhТРН, although in the first cases it was more significant (p < 0.05). In 52,1 % of patients, D-dimer was measured in plasma (mean level - 10785.7 ± 2990.616 ng / ml.) And its high direct correlation with the right ventricle size was determined (r = 0.87, p < 0.001). ) and average - with the left ventricle size of the heart (r - 0.51, p < 0.05).
