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Ивабрадин в комплексной терапии ишемической болезни сердца и ее осложнений
Шалаев С.В., Абатурова О.В., Кремнева Л.В. Ивабрадин в комплексной терапии ишемической болезни сердца и ее осложнений. Consilium Medicum. 2016; 18 (5): 43–47. DOI: 10.26442/2075-1753_2016.5.43-47
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Shalaev S.V., Abaturova O.V., Kremneva L.V. Ivabradine in the complex therapy of coronary heart disease and coronary heart disease complications. Consilium Medicum. 2016; 18 (5): 43–47. DOI: 10.26442/2075-1753_2016.5.43-47
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
В исследованиях последних лет установлена взаимосвязь частоты сердечных сокращений и продолжительности жизни человека. Ивабрадин является представителем нового класса пульсурежающей терапии – блокаторов If-каналов синусового узла. Терапия ивабрадином существенно расширяет возможности фармакологического контроля пациентов со стабильной стенокардией. Исследования по оценке эффективности ивабрадина у больных с острым коронарным синдромом продолжаются.
Ключевые слова: пульсурежающая терапия, ивабрадин, ишемическая болезнь сердца.
Ключевые слова: пульсурежающая терапия, ивабрадин, ишемическая болезнь сердца.
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Studies undertaken in recent years have shown the interaction between the frequency of heart beat and human longevity. Ivabradine is the representative of a novel class of drugs that exclusively reduce heart rate – sinus node If channel inhibitors. Ivabradine treatment significantly enhances the possibility of pharmacological management of patients with stable angina pectoris. The studies on the assessment of efficacy of ivabradine in patients with acute coronary syndrome are continuing.
Key words: rate-lowering therapy, ivabradine, ischemic heart disease.
Полный текст
Список литературы
1. Медико-демографические показатели Российской Федерации – 2006 год. Статистические материалы. М., 2007. / Mediko-demograficheskie pokazateli Rossiiskoi Federatsii – 2006 god. Statisticheskie materialy. M., 2007. [in Russian]
2. Hasenfuss G, Holubarsch C, Herman HP et al. Influence of the force-frequency relationship on haemodynamics and left ventricular function in patients with nonfailing hearts and in patients with dilated cardiomyopathy. Eur Heart J 1994; 15: 164–70.
3. Green SJ, Vaduganathan M, Wilcox JE et al. The prognostic significance of heart rate in patients hospitalized for heart failure with reduced ejection fraction in sinus rhythm. Heart Failure 2013; 6: 488–96.
4. Лугай М.И., Лысенко А.Ф. Анализ медикаментозной терапии ишемической болезни сердца в Украине: результаты исследования PULSAR. Украинский кардиол. журн. 2010; 3: 36–43. / Lugai M.I., Lysenko A.F. Analiz medikamentoznoi terapii ishemicheskoi bolezni serdtsa v Ukraine: rezul'taty issledovaniia PULSAR. Ukrainskii kardiol. zhurn. 2010; 3: 36–43. [in Russian]
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7. Fox K, Ford I, Steg PG et al. Ivabravin for patient with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomized, double-blind, placebo-controlled trial. Lancet 2008; 372: 807–16.
8. Habal МV, Lin PP, Austin PC et al. Association of heart rate at hospital discharge with mortality and hospitalization on patients with heart failure. Circ Heart Failure 2013; p. 1–24.
9. Pepine CJ, Handberg-Thurmond E, Marks RG et al. Rationale and design of the International verapamil SR/Trandolapril Stidy (INVEST): an internet-based randomized trial in coronary artery disease patients with hypertension. JACC 1998; 1 (32): 1228–37.
10. Bangalore S. Steg G, Deedwania P et al. B-bloker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 2012; 308(13): 1340–9.
11. Lechart P, Hulot JS, Escolano S et al. Heart rate cardiac rhytm relationships with bisoprolol benefit in chronic heart failure in CIBIS II Trial. Circulation 2001; 103: 1428–33.
12. Gullestad L, Wikstrand J, Deedwania P et al. MERIT-HF Study Group. What resting heart rate should one aim for when treating patients with heart failure with a beta-blocker? Experiences from the Metoprolol Controlled Release. Extended Release Randomized Intervention Trial in Cronic Heart Failure (MERIT-HF). J Am Coll Cardiol 2005; 45: 252–9.
13. Hartmann F, Katus HA. Beta blockers in heart failure therapy with special reference tj the COPERNICUS Study. Herz 2002; 27: 30–4.
14. Wood S. Right drugs, inadequate dose: do AMI performance measures need dosing data? http// www.medscape.com/viewarticle/809807
15. Фомин И.В. Частота сердечных сокращений при ИБС и ХСН – это банальный фактор или показатель прогноза. Человек и лекарство. Казахстан, 2012; 1 (32): 75–80. / Fomin I.V. Chastota serdechnykh sokrashchenii pri IBS i KhSN – eto banal'nyi faktor ili pokazatel' prognoza. Chelovek i lekarstvo. Kazakhstan, 2012; 1 (32): 75–80. [in Russian]
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17. Cerbai E, De Paoli P, Sartiani L et al. Tratment with irbesartan counteracts the functional remodeling of ventricular myovytes from hypertensive rats. J Cardiovasc Pharmacol 2003; 41: 804–12.
18. Bucchi A, Baruscotti M, DiFrancesco D. Current-dependend block of rabbit sino-atrial node If channel by ivabradin. J Gen Physiol 2002; 120: 1–13.
19. Camm AJ, Lau CP. Electrophysiological effects of a single intravenous administration of ivabradin (S16257) in adult patient with normal electrophysiology. Drug R D 2003; 4: 83–9.
20. Vilaine JP, Bidouard JP, Lesage L et al. Anti-ischemic effects of ivabradin, a selective heart-rate reducing agent, in exercise-induced myocardial ischemia in pigs. J Cardioveasc Pharmacol 2003; 42: 688–96.
21. Couvreur N, Tissier R, Pons S et al. Chronic heart rate reduction with ivabradine improves systolic function of the reperfused heart through a dual mechanism involving a direct mechanical effect and a long-term increase in FKBP12/12.6 expression. Eur Heart J 2010; 31: 1529–37.
22. Zhang RL, Christensen LP, Tomanek RJ. Chronic heart rate reduction facilitates cardiomyocyte survival after myocardial infarction. Anat Rec (Hoboken) 2010; 293: 839–48.
23. Морозова Т.Е., Дурнецова О.С., Вартанова О.А. и др. Рациональный выбор дифференцированной антиангинальной (антиишемической) терапии при стабильной ишемической болезни сердца. Лечащий врач. 2015; 7: 7–11. / Morozova T.E., Durnetsova O.S., Vartanova O.A. i dr. Ratsional'nyi vybor differentsirovannoi antianginal'noi (antiishemicheskoi) terapii pri stabil'noi ishemicheskoi bolezni serdtsa. Lechashchii vrach. 2015; 7: 7–11. [in Russian]
24. Ковалев С.А., Белов В.Н., Белова Е.А. Эффективность коррекции коронарной и сердечной недостаточности ивабрадином у больных ишемической болезнью сердца с низкой сократительной функцией левого желудочка, нуждающихся в хирургической реваскуляризации миокарда. Вестн. новых мед. технологий. 2014; 1. / Kovalev S.A., Belov V.N., Belova E.A. Effektivnost' korrektsii koronarnoi i serdechnoi nedostatochnosti ivabradinom u bol'nykh ishemicheskoi bolezn'iu serdtsa s nizkoi sokratitel'noi funktsiei levogo zheludochka, nuzhdaiushchikhsia v khirurgicheskoi revaskuliarizatsii miokarda. Vestn. novykh med. tekhnologii. 2014; 1. [in Russian]
25. Пархоменко А.Н., Лутай Я.М., Иркин О.И. и др. Эффективность и безопасность раннего применения ингибитора If-каналов ивабрадина у больных с острым Q-инфарктом миокарда с синусовой тахикардией на фоне терапии блокаторами b-адренорецепторов. Украiнський медичний часопис. 2012; 1: 103–10. / Parkhomenko A.N., Lutai Ia.M., Irkin O.I. i dr. Effektivnost' i bezopasnost' rannego primeneniia ingibitora If-kanalov ivabradina u bol'nykh s ostrym Q-infarktom miokarda s sinusovoi takhikardiei na fone terapii blokatorami b-adrenoretseptorov. Ukrains'kii medichnii chasopis. 2012; 1: 103–10. [in Russian]
26. Амосова Е.Н., Руденко Ю.В., Яо Сюй и др. Сравнительная оценка влияния комбинации ивабрадина с метопрололом и монотерапии метопрололом на продольную систолическую и диастолическую функцию левого желудочка и плазменный уровень NT-proANP у больных с острым инфарктом миокарда передней локализации. Сердце i судини. 2012; 4: 52–62. / Amosova E.N., Rudenko Iu.V., Iao Siui i dr. Sravnitel'naia otsenka vliianiia kombinatsii ivabradina s metoprololom i monoterapii metoprololom na prodol'nuiu sistolicheskuiu i diastolicheskuiu funktsiiu levogo zheludochka i plazmennyi uroven' NT-proANP u bol'nykh s ostrym infarktom miokarda perednei lokalizatsii. Serdtse i sudini. 2012; 4: 52–62. [in Russian]
2. Hasenfuss G, Holubarsch C, Herman HP et al. Influence of the force-frequency relationship on haemodynamics and left ventricular function in patients with nonfailing hearts and in patients with dilated cardiomyopathy. Eur Heart J 1994; 15: 164–70.
3. Green SJ, Vaduganathan M, Wilcox JE et al. The prognostic significance of heart rate in patients hospitalized for heart failure with reduced ejection fraction in sinus rhythm. Heart Failure 2013; 6: 488–96.
4. Лугай М.И., Лысенко А.Ф. Анализ медикаментозной терапии ишемической болезни сердца в Украине: результаты исследования PULSAR. Украинский кардиол. журн. 2010; 3: 36–43. / Lugai M.I., Lysenko A.F. Analiz medikamentoznoi terapii ishemicheskoi bolezni serdtsa v Ukraine: rezul'taty issledovaniia PULSAR. Ukrainskii kardiol. zhurn. 2010; 3: 36–43. [in Russian]
5. Heidlan UE, Strauer B.E. Left ventricular muscle mass and elevated heart rate are associated with coronary plague disruption. Circulation 2001; 104: 1477–82.
6. Berton GS, Cordiano R, Palmieri R et al. Heart rate during myocardial infarction: relationship with one-year global mortality in man and women. Can J Cardiol 2002; 18: 495–502.
7. Fox K, Ford I, Steg PG et al. Ivabravin for patient with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomized, double-blind, placebo-controlled trial. Lancet 2008; 372: 807–16.
8. Habal МV, Lin PP, Austin PC et al. Association of heart rate at hospital discharge with mortality and hospitalization on patients with heart failure. Circ Heart Failure 2013; p. 1–24.
9. Pepine CJ, Handberg-Thurmond E, Marks RG et al. Rationale and design of the International verapamil SR/Trandolapril Stidy (INVEST): an internet-based randomized trial in coronary artery disease patients with hypertension. JACC 1998; 1 (32): 1228–37.
10. Bangalore S. Steg G, Deedwania P et al. B-bloker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 2012; 308(13): 1340–9.
11. Lechart P, Hulot JS, Escolano S et al. Heart rate cardiac rhytm relationships with bisoprolol benefit in chronic heart failure in CIBIS II Trial. Circulation 2001; 103: 1428–33.
12. Gullestad L, Wikstrand J, Deedwania P et al. MERIT-HF Study Group. What resting heart rate should one aim for when treating patients with heart failure with a beta-blocker? Experiences from the Metoprolol Controlled Release. Extended Release Randomized Intervention Trial in Cronic Heart Failure (MERIT-HF). J Am Coll Cardiol 2005; 45: 252–9.
13. Hartmann F, Katus HA. Beta blockers in heart failure therapy with special reference tj the COPERNICUS Study. Herz 2002; 27: 30–4.
14. Wood S. Right drugs, inadequate dose: do AMI performance measures need dosing data? http// www.medscape.com/viewarticle/809807
15. Фомин И.В. Частота сердечных сокращений при ИБС и ХСН – это банальный фактор или показатель прогноза. Человек и лекарство. Казахстан, 2012; 1 (32): 75–80. / Fomin I.V. Chastota serdechnykh sokrashchenii pri IBS i KhSN – eto banal'nyi faktor ili pokazatel' prognoza. Chelovek i lekarstvo. Kazakhstan, 2012; 1 (32): 75–80. [in Russian]
16. McAlister FA. Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med 2009; 150: 784–94.
17. Cerbai E, De Paoli P, Sartiani L et al. Tratment with irbesartan counteracts the functional remodeling of ventricular myovytes from hypertensive rats. J Cardiovasc Pharmacol 2003; 41: 804–12.
18. Bucchi A, Baruscotti M, DiFrancesco D. Current-dependend block of rabbit sino-atrial node If channel by ivabradin. J Gen Physiol 2002; 120: 1–13.
19. Camm AJ, Lau CP. Electrophysiological effects of a single intravenous administration of ivabradin (S16257) in adult patient with normal electrophysiology. Drug R D 2003; 4: 83–9.
20. Vilaine JP, Bidouard JP, Lesage L et al. Anti-ischemic effects of ivabradin, a selective heart-rate reducing agent, in exercise-induced myocardial ischemia in pigs. J Cardioveasc Pharmacol 2003; 42: 688–96.
21. Couvreur N, Tissier R, Pons S et al. Chronic heart rate reduction with ivabradine improves systolic function of the reperfused heart through a dual mechanism involving a direct mechanical effect and a long-term increase in FKBP12/12.6 expression. Eur Heart J 2010; 31: 1529–37.
22. Zhang RL, Christensen LP, Tomanek RJ. Chronic heart rate reduction facilitates cardiomyocyte survival after myocardial infarction. Anat Rec (Hoboken) 2010; 293: 839–48.
23. Морозова Т.Е., Дурнецова О.С., Вартанова О.А. и др. Рациональный выбор дифференцированной антиангинальной (антиишемической) терапии при стабильной ишемической болезни сердца. Лечащий врач. 2015; 7: 7–11. / Morozova T.E., Durnetsova O.S., Vartanova O.A. i dr. Ratsional'nyi vybor differentsirovannoi antianginal'noi (antiishemicheskoi) terapii pri stabil'noi ishemicheskoi bolezni serdtsa. Lechashchii vrach. 2015; 7: 7–11. [in Russian]
24. Ковалев С.А., Белов В.Н., Белова Е.А. Эффективность коррекции коронарной и сердечной недостаточности ивабрадином у больных ишемической болезнью сердца с низкой сократительной функцией левого желудочка, нуждающихся в хирургической реваскуляризации миокарда. Вестн. новых мед. технологий. 2014; 1. / Kovalev S.A., Belov V.N., Belova E.A. Effektivnost' korrektsii koronarnoi i serdechnoi nedostatochnosti ivabradinom u bol'nykh ishemicheskoi bolezn'iu serdtsa s nizkoi sokratitel'noi funktsiei levogo zheludochka, nuzhdaiushchikhsia v khirurgicheskoi revaskuliarizatsii miokarda. Vestn. novykh med. tekhnologii. 2014; 1. [in Russian]
25. Пархоменко А.Н., Лутай Я.М., Иркин О.И. и др. Эффективность и безопасность раннего применения ингибитора If-каналов ивабрадина у больных с острым Q-инфарктом миокарда с синусовой тахикардией на фоне терапии блокаторами b-адренорецепторов. Украiнський медичний часопис. 2012; 1: 103–10. / Parkhomenko A.N., Lutai Ia.M., Irkin O.I. i dr. Effektivnost' i bezopasnost' rannego primeneniia ingibitora If-kanalov ivabradina u bol'nykh s ostrym Q-infarktom miokarda s sinusovoi takhikardiei na fone terapii blokatorami b-adrenoretseptorov. Ukrains'kii medichnii chasopis. 2012; 1: 103–10. [in Russian]
26. Амосова Е.Н., Руденко Ю.В., Яо Сюй и др. Сравнительная оценка влияния комбинации ивабрадина с метопрололом и монотерапии метопрололом на продольную систолическую и диастолическую функцию левого желудочка и плазменный уровень NT-proANP у больных с острым инфарктом миокарда передней локализации. Сердце i судини. 2012; 4: 52–62. / Amosova E.N., Rudenko Iu.V., Iao Siui i dr. Sravnitel'naia otsenka vliianiia kombinatsii ivabradina s metoprololom i monoterapii metoprololom na prodol'nuiu sistolicheskuiu i diastolicheskuiu funktsiiu levogo zheludochka i plazmennyi uroven' NT-proANP u bol'nykh s ostrym infarktom miokarda perednei lokalizatsii. Serdtse i sudini. 2012; 4: 52–62. [in Russian]
________________________________________________
1. Mediko-demograficheskie pokazateli Rossiiskoi Federatsii – 2006 god. Statisticheskie materialy. M., 2007. [in Russian]
2. Hasenfuss G, Holubarsch C, Herman HP et al. Influence of the force-frequency relationship on haemodynamics and left ventricular function in patients with nonfailing hearts and in patients with dilated cardiomyopathy. Eur Heart J 1994; 15: 164–70.
3. Green SJ, Vaduganathan M, Wilcox JE et al. The prognostic significance of heart rate in patients hospitalized for heart failure with reduced ejection fraction in sinus rhythm. Heart Failure 2013; 6: 488–96.
4. Lugai M.I., Lysenko A.F. Analiz medikamentoznoi terapii ishemicheskoi bolezni serdtsa v Ukraine: rezul'taty issledovaniia PULSAR. Ukrainskii kardiol. zhurn. 2010; 3: 36–43. [in Russian]
5. Heidlan UE, Strauer B.E. Left ventricular muscle mass and elevated heart rate are associated with coronary plague disruption. Circulation 2001; 104: 1477–82.
6. Berton GS, Cordiano R, Palmieri R et al. Heart rate during myocardial infarction: relationship with one-year global mortality in man and women. Can J Cardiol 2002; 18: 495–502.
7. Fox K, Ford I, Steg PG et al. Ivabravin for patient with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomized, double-blind, placebo-controlled trial. Lancet 2008; 372: 807–16.
8. Habal МV, Lin PP, Austin PC et al. Association of heart rate at hospital discharge with mortality and hospitalization on patients with heart failure. Circ Heart Failure 2013; p. 1–24.
9. Pepine CJ, Handberg-Thurmond E, Marks RG et al. Rationale and design of the International verapamil SR/Trandolapril Stidy (INVEST): an internet-based randomized trial in coronary artery disease patients with hypertension. JACC 1998; 1 (32): 1228–37.
10. Bangalore S. Steg G, Deedwania P et al. B-bloker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 2012; 308(13): 1340–9.
11. Lechart P, Hulot JS, Escolano S et al. Heart rate cardiac rhytm relationships with bisoprolol benefit in chronic heart failure in CIBIS II Trial. Circulation 2001; 103: 1428–33.
12. Gullestad L, Wikstrand J, Deedwania P et al. MERIT-HF Study Group. What resting heart rate should one aim for when treating patients with heart failure with a beta-blocker? Experiences from the Metoprolol Controlled Release. Extended Release Randomized Intervention Trial in Cronic Heart Failure (MERIT-HF). J Am Coll Cardiol 2005; 45: 252–9.
13. Hartmann F, Katus HA. Beta blockers in heart failure therapy with special reference tj the COPERNICUS Study. Herz 2002; 27: 30–4.
14. Wood S. Right drugs, inadequate dose: do AMI performance measures need dosing data? http// www.medscape.com/viewarticle/809807
15. Fomin I.V. Chastota serdechnykh sokrashchenii pri IBS i KhSN – eto banal'nyi faktor ili pokazatel' prognoza. Chelovek i lekarstvo. Kazakhstan, 2012; 1 (32): 75–80. [in Russian]
16. McAlister FA. Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med 2009; 150: 784–94.
17. Cerbai E, De Paoli P, Sartiani L et al. Tratment with irbesartan counteracts the functional remodeling of ventricular myovytes from hypertensive rats. J Cardiovasc Pharmacol 2003; 41: 804–12.
18. Bucchi A, Baruscotti M, DiFrancesco D. Current-dependend block of rabbit sino-atrial node If channel by ivabradin. J Gen Physiol 2002; 120: 1–13.
19. Camm AJ, Lau CP. Electrophysiological effects of a single intravenous administration of ivabradin (S16257) in adult patient with normal electrophysiology. Drug R D 2003; 4: 83–9.
20. Vilaine JP, Bidouard JP, Lesage L et al. Anti-ischemic effects of ivabradin, a selective heart-rate reducing agent, in exercise-induced myocardial ischemia in pigs. J Cardioveasc Pharmacol 2003; 42: 688–96.
21. Couvreur N, Tissier R, Pons S et al. Chronic heart rate reduction with ivabradine improves systolic function of the reperfused heart through a dual mechanism involving a direct mechanical effect and a long-term increase in FKBP12/12.6 expression. Eur Heart J 2010; 31: 1529–37.
22. Zhang RL, Christensen LP, Tomanek RJ. Chronic heart rate reduction facilitates cardiomyocyte survival after myocardial infarction. Anat Rec (Hoboken) 2010; 293: 839–48.
23. Morozova T.E., Durnetsova O.S., Vartanova O.A. i dr. Ratsional'nyi vybor differentsirovannoi antianginal'noi (antiishemicheskoi) terapii pri stabil'noi ishemicheskoi bolezni serdtsa. Lechashchii vrach. 2015; 7: 7–11. [in Russian]
24. Kovalev S.A., Belov V.N., Belova E.A. Effektivnost' korrektsii koronarnoi i serdechnoi nedostatochnosti ivabradinom u bol'nykh ishemicheskoi bolezn'iu serdtsa s nizkoi sokratitel'noi funktsiei levogo zheludochka, nuzhdaiushchikhsia v khirurgicheskoi revaskuliarizatsii miokarda. Vestn. novykh med. tekhnologii. 2014; 1. [in Russian]
25. Parkhomenko A.N., Lutai Ia.M., Irkin O.I. i dr. Effektivnost' i bezopasnost' rannego primeneniia ingibitora If-kanalov ivabradina u bol'nykh s ostrym Q-infarktom miokarda s sinusovoi takhikardiei na fone terapii blokatorami b-adrenoretseptorov. Ukrains'kii medichnii chasopis. 2012; 1: 103–10. [in Russian]
26. Amosova E.N., Rudenko Iu.V., Iao Siui i dr. Sravnitel'naia otsenka vliianiia kombinatsii ivabradina s metoprololom i monoterapii metoprololom na prodol'nuiu sistolicheskuiu i diastolicheskuiu funktsiiu levogo zheludochka i plazmennyi uroven' NT-proANP u bol'nykh s ostrym infarktom miokarda perednei lokalizatsii. Serdtse i sudini. 2012; 4: 52–62. [in Russian]
Авторы
С.В.Шалаев1,2, О.В.Абатурова*1, Л.В.Кремнева3
1 ГБОУ ВПО Тюменский государственный медицинский университет Минздрава России. 625023, Россия, Тюмень, ул. Одесская, д. 54;
2 ГБУЗ ТО Областная клиническая больница №1. 625023, Россия, Тюмень, ул. Котовского, д. 55;
3 ГАУЗ ТО Научно-практический медицинский центр. 625000, Россия, Тюмень, 4-й км Червишевского тракта, д. 7, корп. 1
*obv60kafedra2016@yandex.ru
1 ГБОУ ВПО Тюменский государственный медицинский университет Минздрава России. 625023, Россия, Тюмень, ул. Одесская, д. 54;
2 ГБУЗ ТО Областная клиническая больница №1. 625023, Россия, Тюмень, ул. Котовского, д. 55;
3 ГАУЗ ТО Научно-практический медицинский центр. 625000, Россия, Тюмень, 4-й км Червишевского тракта, д. 7, корп. 1
*obv60kafedra2016@yandex.ru
________________________________________________
S.V.Shalaev 1,2 , O.V.Abaturova*1 , L.V.Kremneva 3
1 Tyumen State Medical University. 625023, Russian Federation, Tyumen, ul. Odesskaia, d. 54;
2 Regional Clinical Hospital №1. 625023, Russian Federation, Tyumen, ul. Kotovskogo, d. 55;
3 Scientific-Practical Medical Center. 625000, Russian Federation, Tyumen, 4-i km Chervishevskogo trakta, d. 7, korp. 1
*obv60kafedra2016@yandex.ru
1 Tyumen State Medical University. 625023, Russian Federation, Tyumen, ul. Odesskaia, d. 54;
2 Regional Clinical Hospital №1. 625023, Russian Federation, Tyumen, ul. Kotovskogo, d. 55;
3 Scientific-Practical Medical Center. 625000, Russian Federation, Tyumen, 4-i km Chervishevskogo trakta, d. 7, korp. 1
*obv60kafedra2016@yandex.ru
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