inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1inovmed-107Research ArticleОБЗОРЫREVIEWSГЛЮКОКОРТИКОИДЫ И АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ У РЕЦИПИЕНТОВ ВНУТРЕННИХ ОРГАНОВGLUCOCORTICOIDS AND ARTERIAL HYPERTENSION IN INTERNAL ORGANS RECIPIENTShttps://orcid.org/0000-0001-8600-0199КосмачеваЕ. Д.KosmachevaE. D.kosmachova_h@mail.ruМартиросянС. М.MartirosyanS. M.martirosyan.krd@mail.ruЗубареваН. А.ZubarevaN. A.olga-kompaniets1@yandex.ruБабичА. Э.BabichA. E.anna-babichl@yandex.ruНаучно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского Министерства здравоохранения Краснодарского края; Кубанский государственный медицинский университет Министерства здравоохранения РФРоссияScientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of Health; Kuban State Medical University, Ministry of Health of the Russian FederationRussian Federation201730122017846064Copyright © Космачева Е.Д., Мартиросян С.М., Зубарева Н.А., Бабич А.Э., 20172017Космачева Е.Д., Мартиросян С.М., Зубарева Н.А., Бабич А.Э.Kosmacheva E.D., Martirosyan S.M., Zubareva N.A., Babich A.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/107

В статье представлен обзор литературных данных о современных взглядах на механизмы глюкокортикоидной артериальной гипертензии у реципиентов донорских органов. Артериальная гипертензия является одним из основных факторов риска сердечно-сосудистых осложнений. На фоне приема глюкокортикоидов повышение артериального давления развивается примерно в 15–20% случаев. Мы обобщили основные механизмы, участвующие в генезе индуцированной глюкокортикоидами артериальной гипертензии: задержка натрия и увеличение объема циркулирующей жидкости, ГК-зависимая вазоконстрикция, повышенный синтез катехоламинов и экспрессия бета 1-адренергических рецепторов, изменение чувствительности к норадреналину в результате повышенного синтеза эндотелина. В практической работе необходимо использовать бесстероидные протоколы или минимизировать дозы у реципиентов внутренних органов, взвешивая риски отторжения трансплантата и возможные нежелательные побочные реакции при приеме глюкокортикоидов.

In this paper we present a review of literary data about the modem views on glucocorticoid arterial hypertension arrangement in donor organs recipients. Arterial hypertension is one of the main risk, pacing for cardiovascular complications development. In cases with glucocorticoids uptake arterial blood pressure develops approximately in 15–20%. We generalized the main schemes participating in genesis of the arterial hypertension induced by glucocorticoids: a time delay of sodium and increase in circulating liquid volume, GC-dependent vasoconstriction, increased synthesis of catecholamines and beta-1 adrenergic receptor expression, change of noradrenaline sensitivity as a result of the increased endothelin synthesis. In a practical manipulation it is necessary to use non-steroid protocols or minimize doses in internal organs recipients, weighing risks of transplant rejection and possible undesirable side responses in cases with glucocorticoids administration.

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