The purpose is to study the effect of hirudotherapy in period of preparing for pregnancy the women with obesity and high risk of developing preeclampsia, on the state of hemostasis and lipid metabolism. Materials and methods. The main group (n=127) was the women with alimentary-constitutional obesity and high risk of developing preeclampsia, received courses of hirudotherapy; the comparison group (n=120) was the women with alimentary-constitutional obesity and the control group (n=50) was somatically healthy women. Hirudotherapy is carried out in accordance with the recommendations of the RF Ministry of health. The study of the basic biochemical parameters and serum lipid spectrum of blood was carried out by standard methods before and during the treatment process, there has also been the main links of hemostasis – platelet, procoagulant and link inhibitors of blood clotting. Results. The efficiency of the preparing for pregnancy in the patients resulted in improvement of general state of women (subjective and objective), contributed to the normalization in the basic biochemical parameters and blood-clotting sequences. The anticoagulant effect of procedures, for example, is manifested in normalization of the parameters of activated partial thromboplastin time and their stability for more than 9 months after the main course of hirudotherapy. Hyperaggregation of platelets with collagen to treatment occurred in 69,3%, after hirudotherapy it declined in all cases to standard values. By the time of pregnancy patients with severe obesity remained in 2,2 times less. Lipid profiles improved relative to a comparison group: total cholesterol decreased by 10.4%, low density lipoproteins – by 34.5%, triglycerides – by 20.8%, atherogenesis coefficient lowering by 1.2 times. Conclusion. Hirudotherapy can be recommended to correct the rheological properties of blood and lipid metabolism, which found out in patients with obesity.
obesity, hirudotherapy, preparing foe pregnancy, hypercoagulability, lipid metabolism.
1. Akusherstvo: natsional´noe rukovodstvo / Aylamazyan E.K., Kulakov V.I., Radzinskiy V.E. [i dr.] / pod red. Aylamazyana E.K. M.: GEOTAR-Medi, 2009. 445 s.
2. Gerashchenko L. Vse o piyavke. Girudoterapiya dlya raznykh tipov lyudey: monografiya. SPb.: Piter, 2007. 256 s.
3. Zhivoglyad R.N. Sistemnyy kompartmentno-klasternyy analiz i upravlenie gomeostazom cheloveka putem girudoterapevticheskikh vozdeystviy: avtoref. dis.... dokt. med. nauk. Tula: Tul´skiy gos. un-t, 2005. 36 s.
4. Ispol´zovanie metoda girudoterapii v prakticheskom zdravookhranenii. Metodicheskie rekomendatsii №2002/78: metodicheskie rekomendatsii / Zhernov V.A., Zubarkina M.M., Karpeev A.A. [i dr.] / Utverzhdeno Minzdravom RF 15.07.2002. [Elektronnyy resurs]. URL: http://www.admoblkaluga.ru/upload/minzdrav/ mu_girudoter.htm (data obrashcheniya: 10.12.2012).
5. Metabolicheskiy sindrom / pod red. chl.-korr. RAMN G.E. Roytberga.- M.: MEDpress-inform, 2007. 224 s.
6. Momot A.P. Sovremennye metody raspoznavaniya sostoyaniya tromboticheskoy gotovnosti: monografiya. - Barnaul: Izd-vo Altayskogo gosudarstvennogo universiteta, 2011. 138 s.
7. Pavlov O.G. Sistemnoe vliyanie nasledstvennoy predraspolozhennosti k somatopatologii i mediko-sotsial´nykh faktorov na techenie beremennosti i iskhod rodov: dis. … dokt. med. nauk. Tula: Tul´skiy gos. un-t, 2006. 295 s.
8. Pavlov O.G. Sistemnoe issledovanie mediko-sotsial´noy determinatsii gestoza. Vestnik novykh meditsinskikh tekhnologiy. 2009. T. 16. №2. S. 135-137.
9. Skvortsova M.Yu. Prognosticheskie kriterii razvitiya gestoza u povtornorodyashchikh s ozhireniem / M.Yu. Skvortsova, T.V. Perova. Materialy IX Vserossiyskogo nauchnogo foruma «Mat´ i ditya». M., 2007. S. 237.
10. Trombogemorragicheskie oslozhneniya v akushersko-ginekologicheskoy praktike: rukovodstvo dlya vrachey / pod red. Makatsariya A.D. M.: MIA, 2011. 1056 s.
11. Izmeneniya reologicheskikh svoystv krovi u bol´nykh s metabolicheskim sindromom / Shilov A.A., Avshalumov A.S., Sinitsina A.S. [i dr.]. Russkiy meditsinskiy zhurnal. 2008. T.16. №4. S. 35-39.
12. Martinelli I., Bucciarelli P., Mannucci P.M. Thrombotic risk factors: basic pathophysiology. Crit. Care Med. 2010. Vol. 38(2 Suppl). P. S3-9.
13. Khadartsev A.A., Yashin A.A., Es´kov V.M., Agarkov N.M., Kobrinskiy B.A., Frolov M.V., Chukhraev A.M., Gondarev S.N., Khromushin V.A., Kamenev L.I., Valentinov B.G., Agarkova D.I. Informatsionnye tekhnologii v meditsine. Monografiya. Tula: TulGU, 2006. 272 s.
