Tsarenko T. Development of ischemic stroke in patients with type II diabetes

The thesis is devoted to a comprehensive study of the hemostasis system in patients with ischemic stroke alone and simultaneously with type 2 diabetes. Significant changes in the coagulation, fibrinolytic system, and platelet disorders were revealed, which indicate the tendency of patients with ischemic stroke alone and simultaneously with type 2 diabetes mellitus to develop thrombosis. All changes were more pronounced in patients with type 2 diabetes, which may be due to a complex of metabolic disorders characteristic for the pathogenesis of this disease. The decrease of plasma clotting time in the “ancistronic time” test, the increase of the activity of factor X indicate the activation of the coagulation cascade in patients with ischemic stroke alone and simultaneously with type 2 diabetes. The decrease of the activity of the fibrinolytic system (the lengthening of the time both lysis of the euglobulin fraction and Hageman-dependent fibrinolysis) lead to a further increase of procoagulatory potential. The imbalance of the content of the key regulators of plasminogen (the significant decrease of the content of TAP and the increase of the content of PAI-1) as well as the increase of factor von Willebrand level indicated the structural and functional changes of endothelium. This could be a mark of the development of endothelial dysfunction in patients with ischemic stroke alone and simultaneously with type 2 diabetes. An increase of the rate and maximum amplitude of platelet aggregation was also revealed. The decrease in total protein concentration, the accumulation of oligopeptides, the increase of pro-inflammatory cytokine content and the appearance of MMP-2 and MMP-9 in the bloodstream indicate disorders of the proteolytic balance and the development of the inflammatory process.