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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">microcirculation</journal-id><journal-title-group><journal-title xml:lang="ru">Регионарное кровообращение и микроциркуляция</journal-title><trans-title-group xml:lang="en"><trans-title>Regional blood circulation and microcirculation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1682-6655</issn><issn pub-type="epub">2712-9756</issn><publisher><publisher-name>Academician I.P. Pavlov First St. Petersburg State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.24884/1682-6655-2017-16-2-4-16</article-id><article-id custom-type="elpub" pub-id-type="custom">microcirculation-106</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group></article-categories><title-group><article-title>Лабораторные тесты и биопсихосоциальный подход при обследовании пациентов с атеросклерозом брахиоцефальных артерий</article-title><trans-title-group xml:lang="en"><trans-title>Laboratory tests and biopsychosocial approach in the examination of patients with brachiocephalic arteries atherosclerosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Соловьева</surname><given-names>Л. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Solovyeva</surname><given-names>L. N.</given-names></name></name-alternatives><email xlink:type="simple">milastukova@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Первый Санкт-Петербургский государственный медицинский университет им. акад. И. П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Academician I. P. Pavlov First St. Petersburg State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>30</day><month>06</month><year>2017</year></pub-date><volume>16</volume><issue>2</issue><fpage>4</fpage><lpage>16</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Соловьева Л.Н., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Соловьева Л.Н.</copyright-holder><copyright-holder xml:lang="en">Solovyeva L.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.microcirc.ru/jour/article/view/106">https://www.microcirc.ru/jour/article/view/106</self-uri><abstract><p>Статья представляет собой обзор литературы, посвященный актуальной теме увеличения эффективности использования лабораторных биомаркеров в контексте применения биопсихосоциального подхода у пациентов с атеросклерозом брахиоцефальных артерий. Лабораторные маркеры являются ценным инструментом диагностики, оценки течения атеросклероза, контроля эффективности терапии. Однако рекомендованный для рутинного использования объем лабораторного обследования пациента с инсультом зачастую недостаточен и не удовлетворяет имеющиеся диагностические и лечебные потребности. Традиционные липидные факторы не всегда являются достаточно надежными прогностическими факторами риска развития инсульта, что определяет необходимость поиска биомаркеров, более значимо связанных с прогрессированием атеросклероза, дестабилизацией атеросклеротической бляшки и риском инсульта. В настоящее время проводятся исследования по «новым» лабораторным маркерам атеросклероза: липопротеин-ассоциированная фосфолипаза А2, С-реактивный белок, определенный высокочувствительным методом, липопротеин (а), ассоциированный с беременностью плазменный белок А, асимметричный диметиларгинин. Однако перечисленные биомаркеры не включены в рекомендации по диагностике инсульта в связи с отсутствием достаточной доказательной базы. Данные опубликованных исследований весьма противоречивы. Предшествующие заболевания пациента, его индивидуальные особенности, образ жизни, психоэмоциональный фон, окружение могут оказывать существенное влияние на развитие атеросклероза, в том числе за счет вмешательства в молекулярные механизмы. Более широкое применение биопсихосоциального подхода, учитывающего данные особенности, позволит глубже разобраться в патобиохимических процессах при атеросклерозе и разработать потенциальные новые мишени медикаментозного и немедикаментозного воздействия. Это, в свою очередь, позволит получить гораздо более точные результаты и повысить эффективность использования лабораторных биомаркеров у пациентов с атеросклерозом и высоким риском инсульта на этапе диагностики и лечения.</p></abstract><trans-abstract xml:lang="en"><p>This article is a literature review aimed at consideration of the ways to increase the effective use of laboratory biomarkers in the context of biopsychosocial approach in patients with atherosclerosis of brachiocephalic arteries. Laboratory markers are a valuable diagnostic tool to evaluate atherosclerotic plaque progression and assess treatment effectiveness. However, according to up to date guidelines only few biomarkers are recommended to routine use in stroke patients. Hence, their analysis does not provide enough information to satisfy diagnostic and therapeutic needs. The parameters of general lipid profile can not serve as a reliable predictor of stroke risk, so we need to find biomarkers more significantly associated with progression of atherosclerosis, atherosclerotic plaque destabilization and stroke risk. Many studies on novel laboratory markers of atherosclerosis (lipoprotein-associated phospholipase A2, high sensitive C reactive protein, lipoprotein (a), pregnancy-associated plasma protein A and asymmetric dimethylarginine) have been performed in the recent years. However, these biomarkers are not included in the guidelines for stroke evaluation due to the lack of sufficient evidence. The published data are very contradictory. History of previous disease, individual characteristics of the patient, lifestyle, vitality, psycho-emotional background and social environment may all have a significant impact on atherosclerosis development and progression due to their influence on molecular mechanisms. Increased use of biopsychosocial approach that takes into account these features will result in better understanding of biochemical processes in patients with atherosclerosis and will contribute to identification of new targets for drug and non-drug treatment. This will provide much more accurate results and more efficient use of laboratory biomarkers in patients with high risk of stroke during their diagnostic evaluation and treatment.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>атеросклероз</kwd><kwd>биомаркеры</kwd><kwd>инсульт</kwd><kwd>реабилитация</kwd><kwd>биопсихосоциальный подход</kwd><kwd>АДМА</kwd><kwd>СРБ</kwd><kwd>ЛП-ФЛА2</kwd><kwd>Лп(а)</kwd><kwd>PAPPA</kwd><kwd>atherosclerosis</kwd><kwd>biomarkers</kwd><kwd>stroke</kwd><kwd>rehabilitation</kwd><kwd>bio-psycho-social approach</kwd><kwd>ADMA</kwd><kwd>CRP</kwd><kwd>LP-PLA2</kwd><kwd>Lp(a)</kwd><kwd>PAPPA</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Алексеенко С. Н., Дробот Е. В. Профилактика заболеваний: учеб. пособие для студ. высших учеб. завед. М.: Академия естествознания, 2015. С. 245.</mixed-citation><mixed-citation xml:lang="en">Алексеенко С. 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