The purpose of the study was an assessment of the quality of life and respiratory disappearances in patients with chronic obstructive pulmonary disease and essential hypertension in the context of the study of apoptosis markers and a thiol-disulfide balance. Materials and methods. The results of the study are based on the data of a comprehensive examination and dynamic observation of 121 patients of both sexes aged 30 to 67 years, who were examined in the period 2016-2018 and received inpatient treatment at the municipal non-profit enterprise "Zaporizhzhya Regional Clinical Hospital" of Zaporizhzhya regional council. The patients were divided into 3 groups, comparable in age and sex: the main group included 40 patients with chronic obstructive pulmonary disease stage II-III (moderate) in combination with essential hypertension stage II of different cardiovascular risk (mean age 50.81±0.99 years); the 1st comparison group included 48 patients with chronic obstructive pulmonary disease stage II-III (mean age 50.7±1.53 years); the second comparison group consisted of 33 patients with essential hypertension stage II with different cardiovascular risk (mean age 51.68±1.22 years). To determine the reference values of the studied indicators, 20 healthy individuals were examined as a control group. Results and discussion. In patients with chronic obstructive pulmonary disease, in combination with essential hypertension, a reliable element of the pro-apoptotic marker of Caspase-7 was established compared with the group of patients with an isolated essential hypertension and a group of patients with chronic obstructive pulmonary disease (by 3.73 and 2.16 times, respectively; p <0.05). The highest level of Caspase-9 was noted in the group of patients with the comorbidity of the chronic obstructive pulmonary disease and essential hypertension, and exceeded the same indicator in patients with essential hypertension by 60% and chronic obstructive pulmonary disease by 85.83% (p <0.05). The comorbidity of the flow of chronic obstructive pulmonary disease and essential hypertension is accompanied by a violation of thiol-disulfide balance and the antioxidant properties of the body. This is confirmed by the lower activity of antioxidant glutathion-dependent enzymes (glutathione transferase, glutathione reductase and glutathione peroxidase) compared with patients with monopathology (2.57±0.32, 0.87±0.13 and 4.25±0.63 μmol/(min*g protein), respectively; p <0.05), with a decrease in the ratio of reduced/oxidized glutathione forms (3.81±0.34 conventional units; p <0.05). At the same time, in patients with chronic obstructive pulmonary disease and essential hypertension, a decrease in the potential of a thiol-disulfide system was noted by 2 times when compared with essential hypertension patients and 1.7 times – when compared with the chronic obstructive pulmonary disease group (p <0.05). Conclusion. According to the results of single-factor dispersion analysis, the key characteristic of the quality of life (on the St. George’s Respiratory Questionnaire scale) the following factors are most significantly influenced: the index of patch-years (F = 21.80; p <0.01), the duration of the chronic obstructive pulmonary disease (f = 19.35; p <0.01), forced expiratory volume 1 (F = 21.80; p <0.01), elderly age (F = 9.49; p <0.01), as well as activation of apoptotic mechanisms (F = 11.90; p <0.01), the intensification of free-radical reactions (F = 8.60; p <0.01), a violation of a thiol-disulfide balance (F = 10.69; p <0.01), the expression level of the ST2 protein (F = 14.42; p <0.01)
Predicting the outcomes and costs for a cohort of 426 patients with Chronic Obstructive Pulmonary Disease (COPD) in Bulgaria through a Markov model