Shvets L. Respiratory muscular dysfunction and a homocysteine level in patients with systemic sclerosis: clinical and pathogenetic significance

Research theme - respiratory muscular dysfunction in patients with systemic sclerosis (SSc) associated with scleroderma, myopathy in mice C3H; aim - to improve diagnosis of respiratory system impairment in subjects with SSc based on the analysis of clinical and pathogenetic significance of respiratory muscle dysfunction and blood level of homocysteine (Hcy), their relationship with the course of the disease; methods - clinical, anthropometric, immune-fermentative, instrumental, morphological, questioning, statistical; novelty and resalts - for the first time the functional state of respiratory muscles (RM) in patients with SSc was assessed and the presence of respiratory muscle dysfunction in a form of weakness and fatigue RM was found. Additionally, an experiment on a C3H mice model with SSc showed that the pathological sclerodermal process of the skin was accompanied by impairment of respiratory muscles with formation of degenerative and fibrotic changes. It was found that Hcy blood level was raised in these animals and was associated with lung injury; the structural characteristics of the lung tissue of animals were verified. It was proved that the weight loss in patients with SSc was due to the loss of muscular component, formation of RM dysfunction which manifested by significant reduction of expiratory and inspiratory muscle strength and their fatigue. In addition, the interrelation between respiratory muscle dysfunction and the course of the disease, lung function, functional ability of patients and their tolerance to physical stress was established. For the first time it was shown that the blood level of Hcy in patients with SSc was associated with the development of pulmonary fibrosis and restrictive changes in the lungs. The presence of strong associative relations between the quality of life of patients with SSc and dyspnoe, the functional state of RM, disease activity and severity of vascular and ventilation disorders were established; it was introduced into practice of therapeutic and preventative institutions of Vinnytsya, Khmelnitskiy regions, and also into a teaching process of Donetsk and Vinnytsya Medical Universities; application - diagnostic and treatment process in rheumatological and medical departments, a teaching process in therapeutic faculties of medical universities.