[The advantages of dynamic evaluation of measurement quality in clinical diagnostic laboratory].

The national standard of laboratory quality control is based on a assumption about normal distribution of random error. The data of procedure of quality control get from analyzer Flexor XL during three months period were examined. The distributions of random error were non-Gauss ones in almost half of all examined tests by reason of both abnormal asymmetry and excess. To prevent possible clinical mistakes the actual level of quality is to be evaluated using dynamic values of bias, variation coefficient and o-metrics based on simple consecutive means. The most appropriate time of averaging consisted about 10 days and had no dependencies of type of test. The actual standard cab y easily improved taking into account the discovered advantages and simplicity of proposed approach.

[Endothelial dysfunction is a target for combination antihypertensive therapy in hypertensive patients with type 2 diabetes mellitus].

AIM: To evaluate the impact of combination antihypertensive therapy with lisinopril + amlodipine (Ekvator) on endothelial dysfunction in patients with hypertension and concurrent type 2 diabetes mellitus (T2DM). SUBJECTS AND METHODS: The trial enrolled 30 patients aged 40 to 65 years with Stages II-Ill hypertension concurrent with T2DM. All the patients received combination antihypertensive therapy with lisinopril + amlodipine (ekvator) for 12 weeks. Endothelial function was studied from serum and urinary NO and endothelin-1 concentrations and occlusion test results. 24-hour blood pressure (BP) monitoring and echocardiography were performed; arterial elastic properties and renal function were investigated. RESULTS: After 12-week therapy, 93.3% of the patients achieved BP goals. Endothelial function was improved in hypertensive patients with T2DM: there were increases in both serum and urinary NO production (by 53.5 and 57.1%, respectively) and decreases in serum and urinary endothelin-1 secretion (by 27.7 and 69.6%, respectively). The number of patients with normal microcirculation increased from 13.3 to 73.3% (p < 0.001). There was significant improvement in 24-hour AP monitoring readings and reductions in the left ventricular mass index by 10.7% and microalbuminuria by 27.7%; the number of patients with increased pulse wave velocity along the elastic arteries declined by 30%. CONCLUSION: Twelve-week treatment with the combined antihypertensive medication ekvator is highly effective and safe for recovering endothelial function and improving the state of target organs in hypertensive patients with T2DM.