Hypertension in Henoch-Schönlein Purpura
Introduction. The purpose and objectives of the work were to evaluate the incidence of hypertension in patients with Henoch-Schönlein purpura, its correlation with clinical signs of the disease, to determine pathogenetic significance of changes in the adsorption-rheological properties of the blood and endothelial function of vessels. Material and methods. The study included 144 patients (56 % men and 44 % women) aged 14 to 65 years, disease duration was 9 years, acute course took place in 24 % of cases, 2nd —3rd degree of activity of pathological process was detected in 68 % of patients. Results. Hypertension is observed in every fourth patient that is closely associated with renal, pancreatic and liver diseases, the damage of the metacarpophalangeal, wrist, sacroiliac and vertebral joints, with the development of osteocystosis and arthrocalcifications, violations of myocardial excitability, changes in its valve apparatus, the size of chambers, left ventricular diastolic dysfunction, systolic pressure in the pulmonary artery, ratio of pulmonary and peripheral vascular resistance. There are detected the disorders of the adsorption-rheological properties of blood serum and vascular endothelial function, which manifested by increased parameters of bulk viscosity, surface tension, interfacial surfactant activity, phase angle of tensiorheograms, endothelin-1, thromboxane A2, homocysteine and cyclic guanosine monophosphate levels on the background of decreased values of the surface viscosity, module of viscoelasticity, relaxation time, the inclination angle of tensiograms, parameters of prostacyclin- and nitritemia. There are no differences between certain parameters in patients with normal and high blood pressure. Conclusions. Above mentioned factors of physical and chemical surface-active, viscoelastic and relaxation properties of blood serum, vasoconstrictive and vasodilatory indicators of vascular endothelial function are not directly involved in the pathogenesis of hypertension that determines the necessity of further studies of other possible components of increased pressure in these patients.
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