THE IMPLICATION OF SOLUBLE MOLECULES OF CELLULAR ADHESION IN THE PROGRESSION OF COPD IN OVERWEIGHT PATIENTS
Due to the high prevalence rates, severity, high risk of disability and death, chronic obstructive pulmonary disease (COPD) still remains an extremely important medical and economic problem not only in Ukraine but also worldwide. According to the WHO estimates, at least 65 million people on our planet suffer from moderate or severe COPD. The severity of the disease and its prognosis are often determined by the influence of concomitant pathology on the frequency of exacerbations, so the problem of comorbidity is becoming increasingly important. Recently, the number of patients with a combination of COPD and overweight is increasing, which is considered as a mutual aggravating factor and negatively affects the prognosis of the disease in such patients. The basis of treatment of patients with COPD is to reduce symptoms, prevent and treat exacerbations, improve exercise tolerance and prevent the progression of the pathology.
The objective of the research: to assess the value of sICAM-1 in blood serum as a marker of inflammation and criterion for the treatment of the destabilization phase in COPD III degree of bronchial obstruction in overweight patients.
112 patients with chronic obstructive pulmonary disease (COPD GOLD III) were examined in different phases of pathological process. The main treatment group involved 45 patients suffering from COPD ІІІ degree of bronchial obstruction (subgroup I included 18 patients (40%) with stable phase of pathological process, subgroup II involved 27 patients (60%) at exacerbation phase), and the experimental group consisted of 67 COPD patients with ІІІ degree of bronchial obstruction (subgroup I included 25 patients (37.3%) with stable phase of pathological process; subgroup II involved 42 patients (62.7%) at exacerbation phase).
The control group involved 23 apparently healthy individuals (AHI). The pulmonary function (PF) test was performed by means of “SPIROKOM” device (Ukraine). The degree of overweight was determined by calculating the body mass index (BMI) using the formula І = m/h² (m – body mass in kilograms, h – height, square of the height in meters (kg/m²). The levels of systemic inflammatory markers were determined by quantitative methods in blood serum: levels of sICAM-1 were identified using ELISA kits (Dialcone, France). While evaluating these indices in the complex therapy of COPD of III degree of bronchial obstruction in patients with overweight, a positive dynamics of its levels was observed on the 10th day. But more significant changes were observed three months after the treatment in those patients who agreed to modify their lifestyle as part of the comprehensive treatment of COPD III degree of bronchial obstruction. According to the research, we found an increase in sICAM-1, more significant in overweight patients, which is one of the manifestations of systemic inflammation in COPD III degree of bronchial obstruction, and complex therapy of this pathology is more effective when modifying the lifestyle of patients.
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