[The stage of portal blood flow in patients with hemoblastosis combined with chronic hepatitis].

109 patients with hemoblastosis (HB) were examined. Average age was 31.8 +/- 1.4 years in group of lymphogranulomatosis patients, and 44 +/- 5.3 years in group of acute leukemia patients. Group of 46 patients with clinical laboratory signs of hepatic lesion was marked out. Since features of portal blood flow (PBF) revealed at dopplerography did not depend on hepatitis aetiology, all patients with chronic hepatitis were analyzed in one group. These patients were examined clinicobiochemically: functional hepatic tests, markers of viral hepatitis B and C, ultrasonic abdominal scanning, PBF dopplerography, puncture biopsy of hepar. All patients had PBF disturbances such as decrease of portal vein blood flow, increase of venous drainage of hepar and spleen. The degree of disturbances intensity increased depending on degree of chronic hepatitis activity (the index of histological activity) and hepatic fibrosis stage. Thus, presence of chronic hepatitis in HB patients regardless of aetiology, is the factor aggravating patients' stage and corrupting PBF. PBF disturbances (decrease of arterial and venous inflow and increase of venous outflow) and development of fibrous changes apparently related with compression of vessels by connective tissue around central veins, inside of lobules and among of hepatic cells. Consequence of it is including anastomosises in blood flow which leads to redistribution of PBF and portal hypertension forming.

[Trimetazidine effects on exercise tolerance and left ventricular diastolic function in patients with coronary heart disease]. / Vliianie terapii trimetazidinom na tolerantnost' k fizicheskoi nagruzke i diastolicheskuiu funktsiia levogo zheludochka serdtsa u bol'nykh ishemicheskoi bolezn'iu serdtsa.

AIM: Trial of trimetasidine effects on exercise tolerance (ET) and left ventricular diastolic function (LVDF) in patients with coronary heart disease (CHD). MATERIALS AND METHODS: The study group included 40 CHD patients. Of them 10, 18 and 12 had myocardial infarction, unstable angina pectoris and stable angina, respectively. 38 CHD patients of the control group had these disorders, respectively, in 5, 15 and 18 cases. 2-3-month therapy with nitrates, beta-blockers (BB) and inhibitors of angiotensin-converting enzyme (ACE) was given to both groups with adjuvant trimetasidine (60 mg/d) given to patients of the study group. The effects were judged by the results of cycle exercise tests and echo-CG including the loading one. RESULTS: Adjuvant use of trimetasidine improved exercise tolerance, mean threshold capacity, LVDF. When added to BB treatment, trimetasidine reduced damage to LVDF under dipiridamol test. CONCLUSION: Trimetasidine addition to combined treatment of CHD raises exercise tolerance and improves LVDF.