Обоснование эффективности применения медикопсихологической реабилитации и цифровой психофизиологической терапии в регуляции формирования атеросклеротического процесса на уровне нейропептидно-цитокиновыхзвеньев иммунной системы при полиморбидной сердечно-сосудистой патологии, протекающей на фоне расс

Abstract

Scientific medical literature has accumulated a lot of data suggesting most important components of coronary heart disease pathogenesis and hypertension to be complex triggering processes of neuro-immune and neuro-endocrine interactions. Risk factors for cardiovascular diseases at the initial stages of atherosclerosis formation cause endothelial dysfunction and trigger a cascade of immune inflammation in coronary vessels, which is based on shifting immune response towards activation of lymphocytes, with predominance of cellular immune reactions. As a rule, it results in remodeling of the vascular wall under participation of proinflammatory cytokines, shifting blood lipid balance towards atherogenicity, destabilization of atherosclerotic plaque, development of thrombosis and acute coronary syndrome. In this respect, the aim of our work was to develop treatment methods that allow, under participation of endogenous immune regulators, to change the structure of pro-atherogenic links via their interactions at the initial stages of the atherosclerotic lesion formation in chronic coronary heart disease and hypertension. To achieve this goal, 80 patients (men) were selected among the marine specialists of the ship crews serving in the Arctic latitudes and the Far North, with ischemic heart disease, stage 1 hypertension and astheno-neurotic disorders with anxiety and depressive manifestations. The groups of patients were formed as follows: Group 1 (n = 31, patients who received standard therapy with cardiotropic drugs; Group 2 (n = 29), subjects who underwent drug correction with weak tranquilizers as a part of standard cardiotropic therapy; Group 3 (n = 34), standard therapy accompanied by medical and psychological rehabilitation and digital psychophysiological therapy. Effectiveness of the treatment was studied by assessing the dynamics of parameters characterizing the neuropeptide-cytokine immune status, the markers used in the diagnostics of atherosclerosis, as well as paired relationships between them. The laboratory part of the work was represented by a set of diagnostic kits, including markers of atherosclerotic process, and test systems for determination of β-endorphin, proinflammatory cytokines (TNF α, IL-1 β, IL-6), and anti-inflammatory (IL-4, IL-10) spectrum. We have found that the use of medical and psychological rehabilitation, along with digital psychophysiological therapy contributes to optimization of neuropeptide-cytokine interactions, thus showing efficiency of cardiotropic drugs usage. It seems to correct the relationships within proatherogenic structures of immune system and pathogenetic links involved in development of atherosclerotic process in polymorbid cardiovascular pathology from marine specialists with intense workloads.