urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/2071-5943-2023-22-6-104-112urmj-1373Research ArticleСтатьиВлияние алкогольной зависимости на течение хронической сердечной недостаточности у больных с ВИЧ-инфекциейThe influence of alcohol dependence on the course of chronic heart failure in patients with HIV infectionhttps://orcid.org/0000-0002-3336-229XГорячеваО. Г.GoryachevaO. G.

Ольга Георгиевна Горячева, кандидат медицинских наук, доцент

кафедра пропедевтики

Пермь

Olga G. Goryacheva, PhD (Medicine), Associate Professor

Perm

o.goryacheva@mail.ruhttps://orcid.org/0000-0002-0168-3785ТерехинаН. А.TerekhinaN. A.

Наталья Александровна Терехина, доктор медицинских наук, профессор, завкафедрой

кафедра биохимии

Пермь

Natalya A. Terekhina, Doctor of Science (Medicine), Professor

Perm

terekhina@list.ruhttps://orcid.org/0000-0001-5633-0242ТерехинГ. А.TerehinG. A.

Георгий Анатольевич Терехин, доктор медицинских наук, профессор, завкафедрой

кафедра экстремальной медицины и товароведения

Пермь

Georgy A. Terehin, Doctor of Science (Medicine), Professor

Perm

terehin-ga@yandex.ruПермский государственный медицинский университет имени академика Е. А. ВагнераРоссияE. A. Wagner Perm State Medical UniversityRussian FederationПермская государственная фармацевтическая академияРоссияPerm State Pharmaceutical AcademyRussian Federation202324122023226104112Copyright © Горячева О.Г., Терехина Н.А., Терехин Г.А., 20232023Горячева О.Г., Терехина Н.А., Терехин Г.А.Goryacheva O.G., Terekhina N.A., Terehin G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1373   Введение

   Введение. Алкогольная зависимость – состояние, последствия которого у лиц с заболеваниями сердечно-сосудистой системы и иммунодефицитом характеризуются тяжелым течением.

   Цель исследования – оценить влияние алкогольной зависимости на течение хронической сердечной недостаточности у лиц, инфицированных вирусом иммунодефицита человека.

   Материалы и методы

   Материалы и методы. Клиническое исследование с включением 240 больных с ВИЧ-инфекцией, из них у 160 диагностирована хроническая сердечная недостаточность (ХСН), у 72 выявлена алкогольная зависимость. Шкала AUDIT применялась для диагностики алкогольной зависимости. Всем больным проведена эхокардиография, в плазме крови определена концентрация NT-proBNP, в сыворотке – содержание СРБ, трансферрина, ферритина, железа, калия, натрия, билирубина, креатинина, мочевины, мочевой кислоты, активность АСТ, АЛТ, гаммаглута-милтранспептидазы (ГГТП). Статистические расчеты: методы Колмогорова – Смирнова, Манна – Уитни, отношения шансов и рисков.

   Результаты

   Результаты. В группе больных с алкогольной зависимостью преобладали застойные явления, более низкая частота сердечных сокращений. На фоне алкогольной зависимости в сыворотке крови установлено снижение уровня общего холестерина, трансферрина, калия, повышение содержания общего билирубина и активности ГГТП, снижение количества тромбоцитов. В плазме крови установлено увеличение концентрации NT-proBNP.

   Обсуждение

   Обсуждение. Алкоголю свойственен кардиотоксический эффект, а регулярное употребление этанола сопряжено с развитием неишемической дилатационной кардиомиопатии и ХСН. Эхокардиографические данные свидетельствуют о преобладании дилатации правого предсердия и левого желудочка в группе больных с алкогольной зависимостью среди всех больных с ХСН, инфицированных ВИЧ, вследствие формирования кардиомиопатии.

   Заключение

   Заключение. Алкогольная зависимость является состоянием, утяжеляющим течение ХСН у больных с ВИЧ-инфекцией, что проявляется более высокими значениями NT-proBNP плазмы крови, при этом ХСН чаще приобретает застойный характер. Течение ХСН у ВИЧ-инфицированных на фоне алкогольной зависимости сопровождается нарушениями работы печени, в 3,5 раза увеличивается шанс развития холестаза, в 2,5 раза увеличиваются шансы смерти в течение 2 месяцев после поступления в стационар.

   Introduction

   Introduction. Alcohol dependence is a condition, the consequences of which are severe in persons with cardiovascular diseases and immunodeficiency.

   The purpose of the study is to evaluate the influence of alcohol dependence on the course of chronic heart failure (CHF) in persons infected with human immunodeficiency virus (HIV).

   Materials and methods

   Materials and methods. A clinical study including 240 HIV-infected patients, 160 of them were diagnosed with CHF, 72 had alcohol dependence. AUDIIT scale was used for diagnostics of alcohol dependence. All patients underwent echocardiography, NT-proBNP concentration was determined in blood plasma, serum - content of SRB, transferrin, ferritin, iron, potassium, sodium, bilirubin, creatinine, urea, uric acid, AST, ALT, GGTP activity. Statistical calculations: Kolmogorov-Smirnov, Mann-Whitney methods, odds ratios and risks.

   Results

   Results. Congestion, lower heart rate prevailed in the group of patients with alcohol dependence. On the background of alcohol dependence in blood serum there was a decrease in the level of total cholesterol, transferrin, potassium, an increase in total bilirubin and GGTP activity, a decrease in the number of platelets. Increase in NT-proBNP concentration was found in blood plasma.

   Discussion

   Discussion. Alcohol is characterized by cardiotoxic effect, and regular ethanol consumption is associated with the development of non-ischemic dilated cardiomyopathy and CHF. Echocardiographic findings suggest a predominance of right atrial and left ventricular dilatation in the group of patients with alcohol dependence among all patients with CHF infected with HIV due to the formation of cardiomyopathy.

   Conclusion

   Conclusion. Alcohol dependence is a condition aggravating the course of CHF in HIV-infected patients, which is manifested by higher values of blood plasma NT-proBNP, with CHF more often acquiring a congestive character. The course of CHF in HIV-infected patients against the background of alcohol dependence is accompanied by liver dysfunction - 3.5 times increase the chance of cholestasis development, 2.5 times increase the chances of death within 2 months after admission to hospital.

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The authors declare that there are no conflicts of interest present.