Дисфункция эндотелия при ишемических нарушениях мозгового кровообращения

There are different pathogenetic mechanisms underlying the polimorphism of the ischemic stroke (atherothrombosis, cardiocerebral emboly, small vessels changes in arterial hypertension). Among these mechanisms one of the key places belongs to the disturbances of the endothelial function and haemostatic system. Today, endothelial dysfunction is believed to be a crucial step in the pathogenesis of arterial hypertension and atherosclerosis, as well as of their complications, such as ischemic stroke. The aim of this study was to evaluate the endothelial function in patients with acute ischemic stroke using biochemical (level of antithrombin III, von Willebrand factor) and ultrasound (test on endothelial derived vasodilatation of the brachial artery) methods. It was shown that ischemic stroke occurs in the case of dysbalance of endothelial production of substances with procoagulant activity (increase in level of the von Willebrand factor) and anticoagulant activity (decrease in the antithrombin III level), i.e. they occur in the situation of endothelial dysfunction. The ultrasound markers of endothelial dysfunction were also demonstrated in patients with ischemic stroke. The endothelial dysfunction is maximal in acute phase of ischemic stroke, it takes place in all stroke subtypes and is correlated with the degree of neurological deficit.