scholarly journals Influence of microcirculatory disorders in patients with moderate chronic obstructive pulmonary disease and systemic arterial hypertension on acid-base and gas balance of blood.

2018 ◽  
Vol 96 (8) ◽  
pp. 729-734
Author(s):  
E. G. Zarubina ◽  
Y. E. Shaldybina ◽  
I. O. Prokhorenko

Material and methods. The clinical study involved 240patients (228 men and 12 women) aged 40 to 55, they were divided into 3 groups based on the duration of the disease. Patients of the first group suffered COPD disease up to 5 years, in the second group it was up to 10 years and in the third group it was more than 10 years. The degree of disturbance of microcirculation processes was investigated using laser Doppler flowmetry at the multifunction laser diagnostic complex “LAKK-M” (Russia, 2011). The following parameters were evaluated: the average perfusion value, saturation of mixed (capillary) blood, saturation of arterial blood, relative volume of the erythrocyte fraction in the skin of the middle fingertip, the index ofperfusion oxygen saturation in the microcirculation, the index of specific oxygen consumption in the tissue. The following parameters were also calculated: the efficiency of oxygen exchange, the fluorescence indicator of oxygen consumption; analysis of the frequency spectrum in the zone of myogenic, neurogenic and respiratory fluctuations of the blood flow. Results. As part of the study it was found that the increase in the prevalence of hypertension is increased in patients with COPD, depending on the duration of the disease: 2.5 times in patients of the 2nd group and 3.7 times in patients of the 3rd group compared with the patients of the 1st group. Based on the analysis of laser Doppler flowmetry data, the microcirculation index significantly changes in patients with COPD and AH in comparison with patients with isolated COPD by 5.7% (p <0.05) in the 1st group, by 11.8% (p <0.01) and 23.5% (p<0.001) in 2 and 3rd groups, respectively. Conclusion. The role of microcirculatory disorders was established in patients with comorbid pathology in the development of disorders in the gas composition parameters and acid-base balance of blood in patients with chronic obstructive pulmonary disease and systemic arterial hypertension, as well as the relationship between the duration of the anamnesis of comorbid pathology and the severity of the revealed disorders.

Author(s):  
Anna Viktorovna Katicheva ◽  
Nikolai Andreyevich Brazhenko ◽  
Olga Nikolaevna Brazhenko ◽  
Anna Georgievna Chuikova

In modern conditions, chronic tobacco intoxication and chronic obstructive pulmonary disease are widespread and affect the health and life expectancy of patients. Among patients with tuberculosis, chronic tobacco intoxication and COPD are also widespread. Against the background of smoking and chronic obstructive pulmonary disease in patients with tuberculosis of the respiratory system, bronchial obstruction, hypoxemia, impaired capillary pulmonary blood flow, and a decrease in the diffusion capacity of the lungs are determined. A comorbid state is accompanied by the development of oxidative stress, systemic inflammation, endothelial dysfunction. Such changes in combination with dyslipidemia contribute to the development of multifocal atherogenesis, systemic arterial hypertension and the rapid development of cardiovascular pathology


2008 ◽  
Vol 32 (12) ◽  
pp. 973-977 ◽  
Author(s):  
Simone Manca-Di-Villahermosa ◽  
Michela Tedesco ◽  
Maurizio Lonzi ◽  
Francesca R. Della-Rovere ◽  
Anna Innocenzi ◽  
...  

2019 ◽  
Vol 8 (2) ◽  
pp. 21-29 ◽  
Author(s):  
L. D. Khidirova ◽  
D. A. Yakhontov ◽  
S. A. Zenin

Aim. To study the clinical course of atrial fibrillation in patients with arterial hypertension and extracardiac comorbid pathology depending on the administered therapy.Methods. 207 men aged 45–65 years with atrial fibrillation (paroxysmal and persistent) and arterial hypertension in combination with diabetes mellitus (n = 40), abdominal obesity (n = 64) and chronic obstructive pulmonary disease (n = 47) were recruited to a observational cohort study. 56 patients with atrial fibrillation and arterial hypertension but without any extracardiac diseases were included in the comparison group. Clinical and anthropometric parameters were assessed in all patients. Adherence to therapy was estimated with the Morisky-Green test. All patients underwent ECG; electrocardiographic holter monitoring, 24-hour blood pressure monitoring with the Daily Monitoring Systems SCHILLER (Schiller, Switzerland), 2D and M-mode echocardiography using a Vivid 7 device (General Electric, USA). The statistical analysis was performed in the Rstudio software (version 0.99.879, RStudio, Inc., MA, USA).Results. 66% of patients with atrial fibrillation and arterial hypertension had concomitant extracardiac comorbid pathology, of them 20% of had diabetes mellitus, 22% with chronic obstructive pulmonary disease, and 24% with abdominal obesity. The clinical groups were comparable in electro impulse and drug therapy. Patients who received medical treatment were frequently admitted to hospitals for atrial fibrillation recurrence (p<0.001), compared with those who underwent electro impulse therapy. Adherence to antiarrhythmic therapy was low in the entire cohort of patients. There were no significant differences found between the clinical groups.Conclusion. Early diagnosis of the factors contributing to the progression of AF, the prescription of additional therapy for the secondary prevention of arrhythmia and the choice of its optimal treatment strategy may slow the progression of arrhythmia and the development of CHF, which will improve not only the clinical status of patients, but also their prognosis.


Author(s):  
O.S. Tyaglaya

It is known that both chronic obstructive pulmonary disease and arterial hypertension are multifactorial diseases, and develop as a result of a complex interaction of genetic and environmental factors. The purpose of this work was to study the metabolism of caspase-7 and caspase-9 in patients with chronic obstructive pulmonary disease (COPD) in combination with arterial hypertension (AH). Materials and methods. We examined 23 patients with a diagnosis of essential hypertension stage II and COPD stage II without a clinically significant concomitant pathology. The plasma level of caspase-7 and caspase-9 was determined using the appropriate ELISA test systems (manufacturer – Bender Medsystems, Austria) at the Medical and Laboratory Training Centre of Zaporizhzhia State Medical University in accordance with the instructions attached to the kit. The analysis of the dynamics of the studied cysteine ​​proteases indicates a statistically significant elevation of these apoptosis markers in the conditions of hypertension and COPD. The value of caspase-7 in the cohort of patients with COPD + AH significantly exceeded similar figures for the groups of patients with a single pathology presented by AH or COPD, and averaged 0.41 ± 0.09 ng / ml. A statistically significant elevation of the caspase-9 level in patients with COPD + AH up to 2.16 ± 0.29 ng / ml compared with other groups also indicates a more significant induction of apoptotic processes in comorbid pathology than in isolated AH or COPD. Conclusion. The obtained results require further clarification of the nature of the relationship between changes in the metabolism of cysteine ​​proteases and the primacy of pathogenetic processes in the mechanisms of risk formation for complications and progression of ventilation disorders in patients with COPD and comorbid essential hypertension.


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