Gurzhiy E. Mucociliary clearance disorders in patients with chronic obstructive pulmonary disease: diagnostics and treatment

Research subjects: patients with chronic obstructive pulmonary disease (COPD). The aim of the investigation: working out of the optimal mehod of investigation of mucociliary clearance (MCC), study of the peculiarities of MCC in patients with COPD and assessment of drugs with different mechanism of action on the state of MCC with the aim to increase efficacy of treatment of patients with COPD. Methods: clinical, instrumental, biochemical, statistic. Theoretical and practical results: non-invasive procedure of investigation of MCC state in patients with COPD by means of assessment of biochemical parameters of sputum. Peculiarities of disorders of MCC in patients with COPD in dependence with the stage of the disease were established. Advantages of addition of mucolytic agents to the basic therapy of patients with COPD in case of MCC disorders were defined. Additional positive impact of broncholytic agent Spiriva on the state of MCC was shown. Novelty: For the first time absence of a toxic effect of a ferrum-containing preparation “Ferrum-lec” in its inhalation introduction in experiment was revealed. The results obtained cause a possibility of carrying out of the further clinical investigations for introduction of inhalation application of the preparation in diagnostic procedure on investigation of MCC. For the first time a complex assessment of MCC state in patients with COPD by means of investigation of biochemical parameters of sputum was carried out. It was determined, that concentration of medium weight molecules (MWM) and the state of protease-antiprotease system of sputum is a biological marker of MCC disorders. The connection between MCC disorders and the degree of COPD severity, which is manifested by the increase of content of MCC sputum and decrease of a local proteolytic potential of sputum in progressing of COPD was established. The notions about impact of mucolytic preparations and cholinolytic preparation Spiriva on MCC state in patients with COPD, which is manifested by the decrease of contentof MCC sputum and increase of a local proteolytic activity of sputum were supplemented. Implementation: articles, theses, introduction into to teaching processes at high medical schools. Sphere, sector of implementation: medicine