FEATURES OF INFLAMMATION PROCESSES IN CARDIOPULMONAL POLYMORBIDITY
Kharkiv Medical Academy of Postgraduate Education
Sumy State University, Ukraine
Chronic lung disease is a serious problem in modern medicine, due to their prevalence and high rates of disability and mortality. In the structure of chronic diseases of the lungs leading positions belong to chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA). However, from 15 to 55 % of patients, especially those over the age of 40 and with associated tobacco history, had a combination of the symptoms of these diseases. Comorbidity of obstructive lung diseases and hypertension are important medical and social problems because of an increased morbidity, severity of complications, the tendency to a rise in mortality and loss of working capacity of patients. To study the state of systemic inflammation in such patients, we examined the patients with asthma − COPD − overlap syndrome, bronchial asthma and chronic obstructive disease on the hypertension background. The disease was diagnosed based on the data of anamnesis, objective examination, spirometry with a standard reversibility testing for bronchial obstruction with 400 mg salbutamol inhalation and laboratory study (clinical blood count with leukocytogram and determination of the eicosanoid LTB4 serum level by immune enzyme method). The survey was conducted during the remission period, which was characterized by stable clinical symptoms and external respiration indices. The obtained results showed that in the patients with chronic obstructive pulmonary disease on the background of hypertension there were specific changes in the systemic inflammation parameters, namely it concerned the leukocytogram in COPD, the increase in leukocyte count during relative reduction in lymphocytes was characteristic, while in bronchial asthma and asthma − COPD − overlap syndrome there was an elevation in eosinophils, not inherent to chronic patients it obstructive pulmonary disease. The serum level of LTB4 in the patients with hypertension and COPD disease was significantly higher than in those with hypertension only, it was further increased in the patients with bronchial asthma and reached the highest values in asthma − COPD − overlap−syndrome.
Key words: bronchial asthma, chronic obstructive pulmonary disease, asthma − chronic obstructive pulmonary disease − overlap syndrome, arterial hypertension, leukotriene B4.