Chernyshov V. Clinical and genetical aspects of dyslipoproteidemia and ischemic heart disease.

3. Object of the study: CAD, atherosclerosis risk factors, meta-bolic syndrome. Purpose of the study: To work out differentiated approaches to the correctin of dyslipoproteidemia and assessment of the efficacy of hypolipidemic drugs in patients with various risk factors of atherosclerosis. Methods of the study: Clinical, biochemical (functional, fotometry, glucose-oxidase, enzyme, immunoemzyme) genetic, clinical genealogical, instrumental. Practical significance of the obtained results: Practical significance of the test with a standard fat load in diagnosis of early latent impairments of lipid metabolism and its use in practice were demonstrated. The findings of the research allow to improve the quality of prognosis of coronary atherosclerosis course. Based on assessment of the efficacy of hypolipidemic drugs in correction of DLP, differential approaches to treatment were suggested. The capability of hypolipidemic drugs to prevent PPL allows to use standard fat load to control the efficacy of hypolipidemic therapy and differentiated administration of hypolipidemic drugs (statins and fibrates). The necessity of combined administration of ACE inhibitors and hypolipidemic drugs with the purpose to improve the efficacy of antihypertensive therapy in patients with arterial hypertension accompanied by metabolic disorders was substantiated. Novelty of the obtained results: For the first time, it was revealed that DLP in adult children of probands with preliminary CAD was characterized by qualitative changes in the composition of low density lipoproteins (LDLP) even when TC was not sufficiently increased, high degree of inheritance of such indices as cholesterol of HDLP, atherogenicity coefficient, Alpb, Alpe, Alpb/Alpa-i, C LDLP/Alpb, distribution of Alpe in HDLP and LDLP. Determinants of PPL (phenotype of DLP on an empty stomach, history of smoking, alcohol drinking, obesity, glucose intolerance, disease in the mother or both parents, presence of restriction site Xba of alpb gene in hetero-and homozygotic states) were found out. It was established that the response of lipid blood spectrum to submaximal load against a background of PPL depended on the initial metabolic disorders in the patient. The factors which reduce the efficacy of hypolipidemic drugs (inheritance, mutations in the Alp genes), diseases of the liver, smoking young age (under 40) were distinguished. It was established that DLP in patients with AH reduced hypotensive effects of ACE inhibitors and hypotensive effect of the latter was realized at softening DLP against a background of hypolipidemic drugs administration. Degree of introduction: The findings of the research were intro-duced to the work of Institute of Therapy (AMS of Ukraine), Pech-enegi, Blizniuki, Krasnokutsk Central District Hospitals, Kupiansk, Lubotin, Central City Hospitals, (Kharkiv Region), regional hos-pitals of Lvov, Zaporozhie, Ternopol, Sumy, Zhitomir, Chernigov, Cherkassy, Poltava, Kherson, Kirovograd, Crimean Rebublican and Khmelnitsky Regional Cardiology Hospitals, hospitals of Pet-rovskoye and Vahrushevo (Lugansk Region), Slaviansk City Hos-pital (Donetsk region), Gradiska District Hospital (Poltava Re-gion), out-patient department of City Clinical Hospital of Poltava. Sphere of application: Medicine, cardiology