The article focuses on the status of a natural anticoagulant antithrombin III in patients with acute viral myocarditis (AVM) and on modes of treatment thereof. It has been proved that there is a statistically significant correlation between a drop in concentration of antithrombin III and degree of severity of AVM. Convincing, statistically significant data have been obtained that antithrombin III gets increased in AVM patients undergoing complex therapy: in those patients running a mild course of the illness, a mild one presenting with elevated indices for homeostasis, a medium gravity course (diclofenac, heparin, thiotriasoline, quick-frozen plasma), and grave course as well (prednizolon, heparin, thiotriasoline, quick-frozen plasma), which fact can be taken account of in choosing a therapeutic regimen.
The article is devoted to an urgent problem of the status of fibrinogen in patients with acute viral myocarditis and methods of the treatment. It is proved for the first time that a decrease in the concentration of fibrinogen as an indicator of thrombinemia correlates statistically to a great extent with the degree of severity of the condition in patients with acute viral myocarditis. Convincing, statistically significant data have been obtained on a decline in the concentration of fibrinogen in those patients with acute viral myocarditis placed on a complex therapy, running a mild course of the disease, a mild one presenting with elevated indices for hemostasis, and moderately severe course (diclofenac, heparin, thiotriazoline) as well, in grave condition (prednisolone, heparin, thiotriazoline), that can help in choosing of patient treatment tactics.
The author carried out an analysis of first and second wave of the aggregation of platelets in patients with acute virus myocarditis in connection with the stage of clinical course of the disease and therapy done.
Overall thirty-four patients with infectious myocarditis were studied by 9 coagulation techniques. A major proportion of this patient population displayed stage I blood disseminated intravascular coagulation syndrome. Treatment with coagulants, antiaggregants or nonsteroid antiinflammatory drugs resulted in positive dynamics of indices for coagulative and thrombovascular hemostasis, which observation significantly correlated with clinical improvement.
Carried out in this study for the first time was the diagnosis and treatment per groups of degree of severity of the clinical course of infectious myocarditis. According to the classification of the New York Association of Cardiology (1964, 1973), there has been established a clear correlation between the gravity of the process course, hemodialysis and cardiac haemodynamics.
Disturbances were studied in the system of hemostasis, lipid peroxidation, functional condition of the cardiac muscle in patients with acute mild, moderately severe, and severe viral myocarditis. The studies were made before and after the treatment of patients with basal drug preparations, heparin, antioxidants (thiotriasaline, captopril). Therapeutic benefit from treatment with heparin, thiotriasaline was but insignificant in patients with mild, moderately severe, and severe course of the disease. It was only with the adoption of a complex therapy (basal drug preparations, heparin, thiotriasaline, captopril, diuretics) that patients derived clinical-and-laboratory-instrumental-and-social-and-economic benefit from treatment.
