Vіsnik Naukovih Doslіdžen' (Nov 2017)
EFFECTIVENESS OF TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND OSTEOARTHRITIS
Abstract
Chronic obstructive pulmonary disease (COPD ) is a disease of the 21st century. COPD affects 210 million people everywhere, every year 3 million people die of this disease. Under the influence of various factors (smoking, gases, a pair of chemical compounds, products of combustion of fuel), an inflammatory process develops in the tissues of the lungs, which, in the background of morphological changes in them, provides the development of systemic inflammatory manifestations. Systemic inflammation is considered as a component of the pathogenesis of COPD , which ensures the development and progression of numerous complications of the disease. Among the large number of complications and systemic effects of COPD, the development of osteoporosis as the basis of osteoarthritis (OA ) is often isolated. The aim of the study – to investigate the effectiveness of the use of fenspiride hydrochloride in the course of the combined course of COPD and OA. Materials and Methods. Examination of patients was conducted on the basis of pulmonologic and rheumatologic departments of the Poltava Regional Clinical Hospital named after M. V. Sklifosovskyi. The research was carried out on the basis of the Research Institute of Genetic and Immunological Foundations of the Development of Pathology and Pharmacogenetics of the Ukrainian State Medical Education Institute "Ukrainian Medical Dentistry Academy". The evaluation of clinical parameters, function of external respiration was performed with the help of a cardiologic apparatus "Cardio ++" (Ukraine), determination of IL-1β in blood serum of the examined patients was performed using the method of immunoassay analysis. Results and Discussion. 33 patients with middle age (54.4 ± 3.1) years with exacerbation of COPD (Clinical group B – GOLD II) in combination with OA were examined. Duration of COPD was (16.2 ± 2.1) years. Among patients, men were 28 (84.8 %), and women – 5 (15.2 %). All patients smoked, the experience of smoking was (32.4 ± 2.9) pack years. In OA , which was available in patients of the main group in the phase of unstable remission, large joints – knee, shoulder, and leg joints – were involved in the pathological process. Depending on the chosen treatment option, the patients were divided into 2 representative groups – the first and the second. In the complex treatment of COPD in combination with OA attention is given to anti-inflammatory therapy, in particular the action of fenspirid hydrochloride. Conclusions. From our data it follows that in patients with exacerbation of COPD in combination with OA in serum, the content of IL-1β exceeds the level in healthy persons by 14.6 times (p <0.001). It has been established that the additional use of fenspiride hydrochloride during exacerbation of COPD in combination with OA promotes the decrease of the concentration of IL-1β in serum of patients, indicates a decrease in systemic inflammation and promotes prolongation of remission, improvement of the outcome of treatment of patients with the indicated comorbidity.
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