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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">r-n-j</journal-id><journal-title-group><journal-title xml:lang="ru">Российский неврологический журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Russian neurological journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2658-7947</issn><issn pub-type="epub">2686-7192</issn><publisher><publisher-name>МИА</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/2658-7947-2022-27-2-34-42</article-id><article-id custom-type="elpub" pub-id-type="custom">r-n-j-295</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>ИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL RESEARCHES AND CASE REPORTS</subject></subj-group></article-categories><title-group><article-title>Прогнозирование цереброваскулярных осложнений коронарного шунтирования у пациентов без значимых стенозов сонных артерий</article-title><trans-title-group xml:lang="en"><trans-title>Prediction of cerebrovascular complications of coronary artery bypass grafting in patients without significant stenosis of the carotid arteries</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4339-8680</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сырова</surname><given-names>И. Д.</given-names></name><name name-style="western" xml:lang="en"><surname>Syrova</surname><given-names>I. D.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сырова Ирина Даниловна – канд. мед. наук, научный сотрудник лаборатории нейрососудистой патологии, отдела клинической кардиологии</p><p>Кемерово</p></bio><bio xml:lang="en"><p>Dr. Irina D. Syrova – MD, PhD, Research Fellow, Laboratory for Neurovascular Pathology, Department of Clinical Cardiology</p><p>Kemerovo</p></bio><email xlink:type="simple">ira_dan2011@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6128-1737</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Коваленко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kovalenko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">ovaav@kemcardio.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8260-8033</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Трубникова</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Trubnikova</surname><given-names>O. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">olgalet17@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7980-7488</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Малева</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Maleva</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">maleva.o@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ложкин</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Lozhkin</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">lozhis@kemcardio.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6248-5419</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Чернобай</surname><given-names>А. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Chernobai</surname><given-names>A. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">cherag@kemcardio.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2556-3809</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Юркевич</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Yurkevich</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">zhuchea@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2960-6466</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сырова</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Syrova</surname><given-names>Е. А.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">klio-ket2011@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8277-5584</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мамчур</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Mamchur</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">mamchin@kemcardio.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4642-3610</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Барбараш</surname><given-names>О. Л.</given-names></name><name name-style="western" xml:lang="en"><surname>Barbаrach</surname><given-names>O. L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кемерово</p></bio><bio xml:lang="en"><p>Kemerovo</p></bio><email xlink:type="simple">director@kemcardio.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний» Министерства науки и высшего образования Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Research Institute for Complex Issues of Cardiovascular Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Кемеровский государственный медицинский университет» Министерства здравоохранения Российской&#13;
Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Kemerovo State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>14</day><month>05</month><year>2022</year></pub-date><volume>27</volume><issue>2</issue><fpage>34</fpage><lpage>42</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Сырова И.Д., Коваленко А.В., Трубникова О.А., Малева О.В., Ложкин И.С., Чернобай А.Г., Юркевич Е.А., Сырова Е.А., Мамчур И.Н., Барбараш О.Л., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Сырова И.Д., Коваленко А.В., Трубникова О.А., Малева О.В., Ложкин И.С., Чернобай А.Г., Юркевич Е.А., Сырова Е.А., Мамчур И.Н., Барбараш О.Л.</copyright-holder><copyright-holder xml:lang="en">Syrova I.D., Kovalenko A.V., Trubnikova O.A., Maleva O.V., Lozhkin I.S., Chernobai A.G., Yurkevich E.A., Syrova Е.А., Mamchur I.N., Barbаrach O.L.</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.r-n-j.com/jour/article/view/295">https://www.r-n-j.com/jour/article/view/295</self-uri><abstract><sec><title>Введение</title><p>Введение. Примерно у 20% из всех направляемых на коронарное шунтирование (КШ) пациентов выявляются гемодинамически незначимые стенозы сонных артерий. Известно, что снижение эластичности стенок артерий мозга вследствие атеросклероза является фактором риска цереброваскулярных осложнений в кардиохирургии.</p></sec><sec><title>Цель работы</title><p>Цель работы. Построение прогностических моделей, определяющих вероятность декомпенсации хронической ишемии головного мозга (ХИГМ) и развития ранней послеоперационной когнитивной дисфункции (ПОКД) у пациентов, имеющих гемодинамически незначимые стенозы сонных артерий в госпитальном периоде КШ, выполненного в условиях искусственного кровообращения.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. Обследовано 58 больных, имеющих &lt; 50% стенозы сонных артерий, в возрасте 56,2 [52,0; 63,0] года. За 2–3 сут до и на 8–9-й день после операции проводились неврологическое, нейропсихологическое и лабораторно-инструментальные обследования. Степень сужения сонных артерий определялась методом цветного дуплексного сканирования. Выполнялись регрессионный и ROC-анализы.</p></sec><sec><title>Результаты</title><p>Результаты. Декомпенсация ХИГМ на 8–9-е сутки КШ выявлена у 51,7%, ранняя ПОКД – у 63,8% больных. Прогностическими критериями декомпенсации ХИГМ и развития ранней ПОКД стали длительный анамнез артериальной гипертензии, низкая сократительная способность миокарда, оцененная предоперационным показателем «фракция выброса левого желудочка», низкое среднее значение показателей глюкозы плазмы крови в интраоперационном периоде и развитие системной воспалительной реакции с оценкой ≥ 5 баллов по шкале SOFA в 1–2-е сутки после КШ.</p></sec><sec><title>Заключение</title><p>Заключение. С помощью полученных прогностических моделей возможно стратифицировать вероятность декомпенсации ХИГМ и развития ранней ПОКД с целью своевременного назначения профилактического лечения.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Аpproximately 20% of all patients referred for coronary bypass surgery (CABG) have hemodynamically insignificant carotid artery stenoses. It is known that a decrease in the elasticity of the walls of the arteries of the brain due to atherosclerosis is a risk factor for cerebrovascular complications in cardiac surgery. The purpose of the work. Construction of prognostic models determining the probability of decompensation of chronic cerebral ischemia (CIG) and the development of early postoperative cognitive dysfunction (POCD) in patients with hemodynamically insignificant carotid artery stenosis in the hospital period of CABG performed under conditions of artificial circulation.</p></sec><sec><title>Material and methods</title><p>Material and methods. 58 patients with &lt; 50% carotid artery stenosis were examined, age – 56.2 [52.0; 63.0] years. Neurological, neuropsychological and laboratory-instrumental examinations were performed 2–3 days before and 8–9 days after the operation. The degree of narrowing of the carotid arteries was determined by color duplex scanning. Regression and ROC analyses were performed.</p></sec><sec><title>Results</title><p>Results. Decompensation of HIGM on day 8–9 of CABG was detected in 51.7%, early POCD – in 63.8% of patients. The prognostic criteria for the decompensation of the CIG and the development of early POCD were: a long history of arterial hypertension, low myocardial contractility, estimated by the preoperative index «left ventricular ejection fraction», a low average value of plasma glucose in the intraoperative period and the development of a systemic inflammatory reaction, estimated on the SOFA scale of «5 or more points» in 1–2 days after CABG.</p></sec><sec><title>Conclusion</title><p>Conclusion. With the help of the obtained prognostic models, it is possible to stratify the probability of decompensation of HIGM and the development of early POCD in order to prescribe preventive treatment in a timely manner.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>ишемическая болезнь сердца</kwd><kwd>коронарное шунтирование</kwd><kwd>критерии прогноза</kwd><kwd>послеоперационная когнитивная дисфункция</kwd><kwd>хроническая ишемия головного мозга</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cardiac ischemia</kwd><kwd>chronic cerebral ischemia</kwd><kwd>coronary artery bypass grafting</kwd><kwd>postoperative cognitive dysfunction</kwd><kwd>prognosis criteria</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">Fink H.A., Hemmy L.S., MacDonald R., Carlyle M.H., Olson C.M., Dysken M.W., McCarten J.R., Kane R.L., Garcia S.A., Rutks I.R., Ouellette J., Wilt T.J. 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