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Артериальная гипертония и когнитивные функции
Артериальная гипертония и когнитивные функции
Остроумова О.Д., Дудаев В.А., Галеева Н.Ю. Артериальная гипертония и когнитивные функции. Consilium Medicum. 2015; 1: 6–10. DOI: 10.26442/2075-1753_2015.1.6-10
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Аннотация
В статье приведены определение, классификация и патогенетические механизмы нарушения когнитивных функций при артериальной гипертонии (АГ). Обсуждаются данные литературы о взаимосвязи АГ с риском развития деменции. Рассмотрены возможности антигипертензивной терапии в профилактике деменции. Подробно разобраны результаты исследования Syst-Eur (Systolic Hypertension in Europe), в котором антагонист кальция (АК) нитрендипин ± эналаприл снизил риск развития деменции, в том числе новых случаев болезни Альцгеймера, на 50%. Рассмотрены нейропротективные механизмы действия АК в целом и нитрендипина в частности.
Ключевые слова: артериальная гипертония, деменция, когнитивные функции, антигипертензивная терапия, антагонисты кальция, нитрендипин, фиксированные комбинации антигипертензивных препаратов, Энанорм.
Ключевые слова: артериальная гипертония, деменция, когнитивные функции, антигипертензивная терапия, антагонисты кальция, нитрендипин, фиксированные комбинации антигипертензивных препаратов, Энанорм.
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The article presents the definition, classification and pathogenetic mechanisms of cognitive impairment in patients with arterial hypertension (AH). Discusses the literature on the relationship of hypertension with risk of dementia. The possibilities of antihypertensive therapy in the prevention of dementia. Discussed in detail the results of the study Syst-Eur (Systolic Hypertension in Europe), in which the calcium antagonist (CA) nitrendipine ± enalapril reduced the risk of developing dementia, including Alzheimer's disease, new cases, 50%. Neuroprotective action mechanisms are considered as a whole and AK nitrendipine in particular.
Key words: arterial hypertension, dementia, cognitive function, antihypertensive therapy, calcium channel blockers, nitrendipine, fixed combinations of antihypertensive drugs, Enanorm.
Key words: arterial hypertension, dementia, cognitive function, antihypertensive therapy, calcium channel blockers, nitrendipine, fixed combinations of antihypertensive drugs, Enanorm.
Полный текст
Список литературы
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10. Cacciatore F, Abete P, Ferrara N et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 2002; 15: 135–42.
11. Elias PK, D'Agostino RB, Elias MF, Wolf PA. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp Aging Res 1995; 21: 393–417.
12. Singh-Manoux A, Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. J Clin Epidemiol 2005; 58: 1308–15.
13. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension of the European Society of Hypertension: the Task Forse for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31 (7): 1281–357.
14. Borson S, Scanlan J, Brush M et al. The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry 2000; 15: 1021–7.
15. Захаров В.В. Нейропсихологические тесты. Необходимость и возможность применения. Consiliun Medicum. 2011; 2: 82–90. / Zakharov V.V. Nejropsihologicheskie testy. Neobhodimost' i vozmozhnost' primenenija. Consiliun Medicum. 2011; 2: 82–90. [in Russian]
16. Marpillat NL, Macquin-Mavier I, Tropeano A-I et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens 2013; 31 (6): 1073–82.
17. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment or older patients with isolated systolic hypertension. Lancet 1997; 350: 757–64.
18. Forette F, Seux M-L, Staessen JA et al. for the Syst-Eur Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med 2002; 162 (18): 2046–52.
19. Parneti L, Senin U, Mecocci P. Cognitive enhancement therapy for Alzheimer's disease: the way forward. Drugs 1997; 53: 752–68.
20. Mason RP, Leeds PR, Jacob PF et al. Inhibition of excessive neuronal apoptosis by the calcium antagonist amlodipine and antioxidants in cerebellar granule cells. J Neurochem 1999; 72: 1448–56.
21. Zipfel GJ, Lee JM, Choi DW. Reducing calcium overload in the ischemic brain. N Engl J Med 1999; 341: 1543–4.
22. Thibault O, Porter NM, Chen KC. Calcium Dysregulation in neuronal aging and Alzheimer's disease: hystory and new directions. Cell Calcium 1998; 25: 417–33.
23. Poscale A, Etchoberrigaray R. Calcium alterations in Alzheimer's disease: pathophysiology, models and therapeutic opportunities. Pharmacol Res 1999; 39: 81–8.
24. Hong YL. The relationship between calcium antagonist-induced hypotension and central monoaminergic system in spontaneously hypertensive rats. Int J Clin Pharmacol Ther Toxicol 1987; 11: 589–97.
25. Murzenok PP, Huang BS, Leenen FHH. Sympathoinhibition by central and periferal infusion of nifedipine in spontaneously hypertensive rats. Hypertension 2000; 35: 631–6.
26. Gould RJ, Murphy KMM, Snyder SH. Autoradiographic localization of calcium channel antagonist receptors in rats brain with [3H] nitrendipine. Brain Res 1985; 330: 217–33.
27. De la Sierra A, Roca-Cusachs A, Redón J et al. Effectiveness and tolerability of fixed-dose combination enalapril plus nitrendipine in hypertensive patients: results of the 3-month observational, post-marketing, multicentre, prospective CENIT study. Clin Drug Investig 2009.
28. Eber B, Weber T, Artmann A et al. Fixkombination Enalapril/Nitrendipin in der täglichen Praxis – Effektivität und Verträglichkeit bei 1.262 österreichischen Hypertonikern. Journal für Hypertonie 2007; 11 (2): 22–5.
29. Trenkwalder P. The Efficacy and Tolerability of an Antihypertensive Fixed Combination of Enalapril and Nitrendipine. Perfusion 2004; 7: 394–9.
2. Larrieu S. Letenneur L, Orgogozo JM. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002; 59: 1594–9.
3. Levin O.S. Diagnostika i lechenie dementsii v klinicheskoy praktike. M.: MEDpress-inform, 2010. [in Russian]
4. Chazova I.E., Ratova L.G., Boitsov S.A., Nebieridze D.V. Recommendations for the management of arterial hypertension Russian Medical Society of Arterial Hypertension and Society of Cardiology of the Russian Federation. System Hypertension. 2010; 3: 5–26. [in Russian]
5. Henderson AS. Dementia. World Health Organization, Geneva, 1994.
6. Amaducci L, Andrea L. The epidemiology of the dementia in Europe. In: A.Culebras, J.Matias Cuiu, G.Roman (eds): New concepts in vascular dementia. Barselona: Prous Science Publishers, 1993; p. 1927.
7. Zakharov V.V. Narushenie pamyati v pozhilom vozraste: sovremennye vozmozhnosti profilaktiki i terapii. Rus. med. zhurn. 2012; 8: 422–6. [in Russian]
8. Skoog I, Lernfelt B, Landahl S et al. 15-years longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141–5.
9. Launer LJ, Masaki K, Petrovitch H et al. The assoсiation between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. JAMA 1995; 274: 1846–51.
10. Cacciatore F, Abete P, Ferrara N et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 2002; 15: 135–42.
11. Elias PK, D'Agostino RB, Elias MF, Wolf PA. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp Aging Res 1995; 21: 393–417.
12. Singh-Manoux A, Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. J Clin Epidemiol 2005; 58: 1308–15.
13. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension of the European Society of Hypertension: the Task Forse for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31 (7): 1281–357.
14. Borson S, Scanlan J, Brush M et al. The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry 2000; 15: 1021–7.
15. Zakharov V.V. Nejropsihologicheskie testy. Neobhodimost' i vozmozhnost' primenenija. Consiliun Medicum. 2011; 2: 82–90. [in Russian]
16. Marpillat NL, Macquin-Mavier I, Tropeano A-I et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens 2013; 31 (6): 1073–82.
17. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment or older patients with isolated systolic hypertension. Lancet 1997; 350: 757–64.
18. Forette F, Seux M-L, Staessen JA et al. for the Syst-Eur Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med 2002; 162 (18): 2046–52.
19. Parneti L, Senin U, Mecocci P. Cognitive enhancement therapy for Alzheimer's disease: the way forward. Drugs 1997; 53: 752–68.
20. Mason RP, Leeds PR, Jacob PF et al. Inhibition of excessive neuronal apoptosis by the calcium antagonist amlodipine and antioxidants in cerebellar granule cells. J Neurochem 1999; 72: 1448–56.
21. Zipfel GJ, Lee JM, Choi DW. Reducing calcium overload in the ischemic brain. N Engl J Med 1999; 341: 1543–4.
22. Thibault O, Porter NM, Chen KC. Calcium Dysregulation in neuronal aging and Alzheimer's disease: hystory and new directions. Cell Calcium 1998; 25: 417–33.
23. Poscale A, Etchoberrigaray R. Calcium alterations in Alzheimer's disease: pathophysiology, models and therapeutic opportunities. Pharmacol Res 1999; 39: 81–8.
24. Hong YL. The relationship between calcium antagonist-induced hypotension and central monoaminergic system in spontaneously hypertensive rats. Int J Clin Pharmacol Ther Toxicol 1987; 11: 589–97.
25. Murzenok PP, Huang BS, Leenen FHH. Sympathoinhibition by central and periferal infusion of nifedipine in spontaneously hypertensive rats. Hypertension 2000; 35: 631–6.
26. Gould RJ, Murphy KMM, Snyder SH. Autoradiographic localization of calcium channel antagonist receptors in rats brain with [3H] nitrendipine. Brain Res 1985; 330: 217–33.
27. De la Sierra A, Roca-Cusachs A, Redón J et al. Effectiveness and tolerability of fixed-dose combination enalapril plus nitrendipine in hypertensive patients: results of the 3-month observational, post-marketing, multicentre, prospective CENIT study. Clin Drug Investig 2009.
28. Eber B, Weber T, Artmann A et al. Fixkombination Enalapril/Nitrendipin in der täglichen Praxis – Effektivität und Verträglichkeit bei 1.262 österreichischen Hypertonikern. Journal für Hypertonie 2007; 11 (2): 22–5.
29. Trenkwalder P. The Efficacy and Tolerability of an Antihypertensive Fixed Combination of Enalapril and Nitrendipine. Perfusion 2004; 7: 394–9.
2. Larrieu S. Letenneur L, Orgogozo JM. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002; 59: 1594–9.
3. Левин О.С. Диагностика и лечение деменции в клинической практике. М.: МЕДпресс-информ, 2010. / Levin O.S. Diagnostika i lechenie dementsii v klinicheskoy praktike. M.: MEDpress-inform, 2010. [in Russian]
4. Чазова И.Е., Ратова Л.Г., Бойцов С.А., Небиеридзе Д.В. Диагностика и лечение артериальной гипертензии (Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов). Системные гипертензии. 2010; 3: 5–26. / Chazova I.E., Ratova L.G., Boitsov S.A., Nebieridze D.V. Recommendations for the management of arterial hypertension Russian Medical Society of Arterial Hypertension and Society of Cardiology of the Russian Federation. System Hypertension. 2010; 3: 5–26. [in Russian]
5. Henderson AS. Dementia. World Health Organization, Geneva, 1994.
6. Amaducci L, Andrea L. The epidemiology of the dementia in Europe. In: A.Culebras, J.Matias Cuiu, G.Roman (eds): New concepts in vascular dementia. Barselona: Prous Science Publishers, 1993; p. 1927.
7. Захаров В.В. Нарушение памяти в пожилом возрасте: современные возможности профилактики и терапии. Рус. мед. журн. 2012; 8: 422–6. / Zakharov V.V. Narushenie pamyati v pozhilom vozraste: sovremennye vozmozhnosti profilaktiki i terapii. Rus. med. zhurn. 2012; 8: 422–6. [in Russian]
8. Skoog I, Lernfelt B, Landahl S et al. 15-years longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141–5.
9. Launer LJ, Masaki K, Petrovitch H et al. The assoсiation between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. JAMA 1995; 274: 1846–51.
10. Cacciatore F, Abete P, Ferrara N et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 2002; 15: 135–42.
11. Elias PK, D'Agostino RB, Elias MF, Wolf PA. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp Aging Res 1995; 21: 393–417.
12. Singh-Manoux A, Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. J Clin Epidemiol 2005; 58: 1308–15.
13. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension of the European Society of Hypertension: the Task Forse for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31 (7): 1281–357.
14. Borson S, Scanlan J, Brush M et al. The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry 2000; 15: 1021–7.
15. Захаров В.В. Нейропсихологические тесты. Необходимость и возможность применения. Consiliun Medicum. 2011; 2: 82–90. / Zakharov V.V. Nejropsihologicheskie testy. Neobhodimost' i vozmozhnost' primenenija. Consiliun Medicum. 2011; 2: 82–90. [in Russian]
16. Marpillat NL, Macquin-Mavier I, Tropeano A-I et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens 2013; 31 (6): 1073–82.
17. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment or older patients with isolated systolic hypertension. Lancet 1997; 350: 757–64.
18. Forette F, Seux M-L, Staessen JA et al. for the Syst-Eur Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med 2002; 162 (18): 2046–52.
19. Parneti L, Senin U, Mecocci P. Cognitive enhancement therapy for Alzheimer's disease: the way forward. Drugs 1997; 53: 752–68.
20. Mason RP, Leeds PR, Jacob PF et al. Inhibition of excessive neuronal apoptosis by the calcium antagonist amlodipine and antioxidants in cerebellar granule cells. J Neurochem 1999; 72: 1448–56.
21. Zipfel GJ, Lee JM, Choi DW. Reducing calcium overload in the ischemic brain. N Engl J Med 1999; 341: 1543–4.
22. Thibault O, Porter NM, Chen KC. Calcium Dysregulation in neuronal aging and Alzheimer's disease: hystory and new directions. Cell Calcium 1998; 25: 417–33.
23. Poscale A, Etchoberrigaray R. Calcium alterations in Alzheimer's disease: pathophysiology, models and therapeutic opportunities. Pharmacol Res 1999; 39: 81–8.
24. Hong YL. The relationship between calcium antagonist-induced hypotension and central monoaminergic system in spontaneously hypertensive rats. Int J Clin Pharmacol Ther Toxicol 1987; 11: 589–97.
25. Murzenok PP, Huang BS, Leenen FHH. Sympathoinhibition by central and periferal infusion of nifedipine in spontaneously hypertensive rats. Hypertension 2000; 35: 631–6.
26. Gould RJ, Murphy KMM, Snyder SH. Autoradiographic localization of calcium channel antagonist receptors in rats brain with [3H] nitrendipine. Brain Res 1985; 330: 217–33.
27. De la Sierra A, Roca-Cusachs A, Redón J et al. Effectiveness and tolerability of fixed-dose combination enalapril plus nitrendipine in hypertensive patients: results of the 3-month observational, post-marketing, multicentre, prospective CENIT study. Clin Drug Investig 2009.
28. Eber B, Weber T, Artmann A et al. Fixkombination Enalapril/Nitrendipin in der täglichen Praxis – Effektivität und Verträglichkeit bei 1.262 österreichischen Hypertonikern. Journal für Hypertonie 2007; 11 (2): 22–5.
29. Trenkwalder P. The Efficacy and Tolerability of an Antihypertensive Fixed Combination of Enalapril and Nitrendipine. Perfusion 2004; 7: 394–9.
________________________________________________
2. Larrieu S. Letenneur L, Orgogozo JM. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002; 59: 1594–9.
3. Levin O.S. Diagnostika i lechenie dementsii v klinicheskoy praktike. M.: MEDpress-inform, 2010. [in Russian]
4. Chazova I.E., Ratova L.G., Boitsov S.A., Nebieridze D.V. Recommendations for the management of arterial hypertension Russian Medical Society of Arterial Hypertension and Society of Cardiology of the Russian Federation. System Hypertension. 2010; 3: 5–26. [in Russian]
5. Henderson AS. Dementia. World Health Organization, Geneva, 1994.
6. Amaducci L, Andrea L. The epidemiology of the dementia in Europe. In: A.Culebras, J.Matias Cuiu, G.Roman (eds): New concepts in vascular dementia. Barselona: Prous Science Publishers, 1993; p. 1927.
7. Zakharov V.V. Narushenie pamyati v pozhilom vozraste: sovremennye vozmozhnosti profilaktiki i terapii. Rus. med. zhurn. 2012; 8: 422–6. [in Russian]
8. Skoog I, Lernfelt B, Landahl S et al. 15-years longitudinal study of blood pressure and dementia. Lancet 1996; 347: 1141–5.
9. Launer LJ, Masaki K, Petrovitch H et al. The assoсiation between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study. JAMA 1995; 274: 1846–51.
10. Cacciatore F, Abete P, Ferrara N et al. The role of blood pressure in cognitive impairment in an elderly population. J Hypertens 2002; 15: 135–42.
11. Elias PK, D'Agostino RB, Elias MF, Wolf PA. Blood pressure, hypertension, and age as risk factors for poor cognitive performance. Exp Aging Res 1995; 21: 393–417.
12. Singh-Manoux A, Marmot M. High blood pressure was associated with cognitive function in middle-age in the Whitehall II study. J Clin Epidemiol 2005; 58: 1308–15.
13. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension of the European Society of Hypertension: the Task Forse for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31 (7): 1281–357.
14. Borson S, Scanlan J, Brush M et al. The mini-cog: a cognitive 'vital signs' measure for dementia screening in multi-lingual elderly. Int J Geriatr Psychiatry 2000; 15: 1021–7.
15. Zakharov V.V. Nejropsihologicheskie testy. Neobhodimost' i vozmozhnost' primenenija. Consiliun Medicum. 2011; 2: 82–90. [in Russian]
16. Marpillat NL, Macquin-Mavier I, Tropeano A-I et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens 2013; 31 (6): 1073–82.
17. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment or older patients with isolated systolic hypertension. Lancet 1997; 350: 757–64.
18. Forette F, Seux M-L, Staessen JA et al. for the Syst-Eur Investigators. The Prevention of Dementia with Antihypertensive Treatment. New evidence from the Systolic Hypertension (Syst-Eur) Study. Arch Intern Med 2002; 162 (18): 2046–52.
19. Parneti L, Senin U, Mecocci P. Cognitive enhancement therapy for Alzheimer's disease: the way forward. Drugs 1997; 53: 752–68.
20. Mason RP, Leeds PR, Jacob PF et al. Inhibition of excessive neuronal apoptosis by the calcium antagonist amlodipine and antioxidants in cerebellar granule cells. J Neurochem 1999; 72: 1448–56.
21. Zipfel GJ, Lee JM, Choi DW. Reducing calcium overload in the ischemic brain. N Engl J Med 1999; 341: 1543–4.
22. Thibault O, Porter NM, Chen KC. Calcium Dysregulation in neuronal aging and Alzheimer's disease: hystory and new directions. Cell Calcium 1998; 25: 417–33.
23. Poscale A, Etchoberrigaray R. Calcium alterations in Alzheimer's disease: pathophysiology, models and therapeutic opportunities. Pharmacol Res 1999; 39: 81–8.
24. Hong YL. The relationship between calcium antagonist-induced hypotension and central monoaminergic system in spontaneously hypertensive rats. Int J Clin Pharmacol Ther Toxicol 1987; 11: 589–97.
25. Murzenok PP, Huang BS, Leenen FHH. Sympathoinhibition by central and periferal infusion of nifedipine in spontaneously hypertensive rats. Hypertension 2000; 35: 631–6.
26. Gould RJ, Murphy KMM, Snyder SH. Autoradiographic localization of calcium channel antagonist receptors in rats brain with [3H] nitrendipine. Brain Res 1985; 330: 217–33.
27. De la Sierra A, Roca-Cusachs A, Redón J et al. Effectiveness and tolerability of fixed-dose combination enalapril plus nitrendipine in hypertensive patients: results of the 3-month observational, post-marketing, multicentre, prospective CENIT study. Clin Drug Investig 2009.
28. Eber B, Weber T, Artmann A et al. Fixkombination Enalapril/Nitrendipin in der täglichen Praxis – Effektivität und Verträglichkeit bei 1.262 österreichischen Hypertonikern. Journal für Hypertonie 2007; 11 (2): 22–5.
29. Trenkwalder P. The Efficacy and Tolerability of an Antihypertensive Fixed Combination of Enalapril and Nitrendipine. Perfusion 2004; 7: 394–9.
Авторы
О.Д.Остроумова*1,2, В.А.Дудаев1, Н.Ю.Галеева3
1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
3 ГБУЗ ГКБ №70 Департамента здравоохранения г. Москвы. 111399, Россия, Москва, Федеративный просп., д. 17
*ostroumova.olga@mail.ru
1 ГБОУ ВПО Московский государственный медико-стоматологический университет им. А.И.Евдокимова Минздрава России. 127473, Россия, Москва, ул. Делегатская, д. 20, стр. 1;
2 ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2;
3 ГБУЗ ГКБ №70 Департамента здравоохранения г. Москвы. 111399, Россия, Москва, Федеративный просп., д. 17
*ostroumova.olga@mail.ru
________________________________________________
O.D.Ostroumova*1,2, V.A.Dudaev1, N.Yu.Galeeva
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119435, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
3 City clinical hospital №70 of the Moscow health care department. 111399, Russian Federation, Moscow, Federativnyi prosp., d. 17
*ostroumova.olga@mail.ru
1 A.I.Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation. 127473, Russian Federation, Moscow, ul. Delegatskaia, d. 20, str. 1;
2 Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119435, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2;
3 City clinical hospital №70 of the Moscow health care department. 111399, Russian Federation, Moscow, Federativnyi prosp., d. 17
*ostroumova.olga@mail.ru
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