Индивидуальные особенности аутоиммунных нарушений у больных артериальной гипотонией в структуре неврологических симптомoкомплексов органического поражения центральной нервной системы

Abstract

Работа посвящена особенностям формирования индивидуального клинического фенотипа с выраженной гуморальной сенсибилизацией больных артериальной гипотонией в структуре неврологических симптомакомплексов органического поражения центральной нервной системы. Обследован 201 пациент патологи ческой артериальной гипотонией и 45 с физиологической артериальной гипотонией. Выполнено клиническо-неврологическое, допплерографическое обследование, определение состояния иммунорезистентности и гормонального фона. Определена стратегия терапии.This work deals with the special features of formation of individual clinical phenotype with an evident humoral sensitizing in patients with arterial hypotension in structure of neurologic symptom complexes of organic lesion of the central nervous system in accordance with the features of disorders of immune resistance and changes of the hormonal background. Materials and methods. There was carried out an examination of 201 patients: 89 with vegetative dysfunction, 50 in remote period of the closed craniocerebral trauma and 64 with cerebral arachnoiditis on the background of the chronic nidi of infection.45 examined persons with physiological arterial hypotension formed a control group. There were carried out clinical and neurological examinations, monitoring of arterial pressure, definition of the state of the primary, secondary immunity and hormonal background. Results. The main pathogenetic mechanisms in individual clinical phenotype with an evident humoral sensitizing that were formed on the background of the chronic infection are more connected with the humoral link of immunity (the high concentration of circulating immune complexes of the small values of molecular weight and peptides of the mean molecular weight, the growth of IgM content) and form autoimmune disorders. This category can be related to the patients with irreversible functional states that complicates prescription of therapeutic measures. Conclusions. For patients with an evident humoral sensitizing it is reasonable to use desensitizing preparations, enterosorbents, plasmapheresis in the complex treatment. At persistent viral infection the use of specific antiviral immunoglobulins of IgG is recommended.