[Hirudotherapy in combined sanatorium-spa treatment of patients with coronary heart disease].

It is established that patients with coronary heart disease (CHD), received hirudotherapy (HT) as a part of sanatorium-spa treatment (SST), in comparison with patients, received only traditional SST, have tendency to normalization of initially increased levels of general cholesterol (GC) and triglycerides (TG), and to decrease in concentration of low-density lipoproteins (LDL). In elderly patients HT does not have an influence on levels of GC, TG and LDL, but increases level of high-density lipoproteins (HDL). Extension of SST by HT including maintains positive influence on indices of vegetative balance in CHD patients via mild activation of parasympathetic effects. In elderly patients additional prescription of HT sharply amplifies parasympathetic influences against the background of significant depression of sympathetic activity, which in patients with initial sympathicotonia leads to excessive parasympathetic shift of vegetative balance and can result in collapse of vascular tonus and aggravation of ischemic changes in myocardium. Therefore it is necessary to refine indications and contraindications to HT in CHD elderly patients.