Clinical and laboratory characteristics of patients with cardiopulmonary comorbidence
Keywords:COPD, asthma COPD overlap, AH, systemic inflammation, CRP, IL-6, IL-8, TNF-α
Comorbidity of bronchial obstructive diseases and arterial hypertension (AH) is an important medico-social problem due to the increased incidence, the severity of complications, the tendency to increase mortality and disability of patients. However, the clinical characteristics and role of the major markers of inflammation in the pathogenesis of conditions such as chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO) against AH and their impact on the course of the disease remain poorly understood.
The aim of the study is to study the main clinical and laboratory parameters of patients with ACO and COPD with concomitant AH compared with each other and patients with isolated AH and with ACO without AH.
Materials and methods. To participate in the study, we selected 100 patients with ACO on the background of AH, 30 patients with ACO without AH, 30 patients with COPD on the background of AH, 30 patients with AH. Examination of patients included: clinical methods - analysis of complaints and anamnesis of patients, standard clinical examination with measurement of blood pressure and heart rate, anthropometric study with the determination of body mass index (BMI), spirometric study with a test for reversibility of bronchial obstruction, the concentration of interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor α (TNF-α) and C-reactive proteine (CRP) in serum were determined by enzyme immunoassay.
Results. Patients of the surveyed groups did not differ significantly in age and gender composition. There were no significant differences in smoking status and major indicators of respiratory function in the ACO and COPD groups, unlike the AH group. However, the FEV1 increase after bronchodilator inhalation was significantly higher in the ACO groups than in the COPD group and only AH. No significant differences were found between the study groups on TNF-α. At the same time, the group of patients with ACO on the background of AH was significantly different from the group of only ACO, COPD with AH and only AH in terms of CRP and IL-6; for IL-8 there was a significant difference compared with the groups with ACO and COPD with AH, and there were no significant differences with the AH group.
Conclusions. The less prolonged exposure of the smoking factor with the background of bronchial asthma leads to pronounced changes in respiratory function, similar to changes in COPD with greater exposure to smoking. ACO patients have a better reversal of bronchial obstruction in response to bronchodilators than patients with COPD, which may indicate a potential better response of this group of patients to bronchodilator treatment. The course of ACO on the background of AH is accompanied by more pronounced chronic inflammation
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