Bahrii V. Pathogenetic substantiation of differential treatment of erosive-ulcerouslesionsofthestomachandduodenumin patients with chronicobstructivepulmonary disease

The object of the research: erosive-ulcerous lesions of the stomach and duodenum (EULSD) in patients with chronic obstructive pulmonary disease (COPD). Objective - to determine the pathogenetic characteristics of EULSD in patients with COPD and on its basis to improve the method of differentiated treatment. The methods of research: clinical, biochemical, immunoenzymatic, filtration, instrumental, histological and histochemical. Novelty – new mechanisms of the oncet of EULSD have been studied in patients with COPD and the expediency of including amlodipine and rebamipide in the treatment regimen has been demonstrated for the first time in patients afflicted with COPD. Results: an improved differentiated course of treatment of EULSD in 86 patients with COPD has been substantiated via using a 10-day alternative regimen of antihelicobacter therapy (rabeprazole, amoxicilline, levofloxacine) in case of H. pylori-associated peptic ulcers and an inclusion of amlodipine and rebamipide in the treatment regimen (irrespective of the presence of H. pylori) that was conducive to an improvement of the functional state of the endothelium, the morpho-functional properties of the erythrocytes, an elimination of the manifestations of the hypercoagulation syndrome, a decrease of the intensity of lipid peroxidation, oxidative protein modification, of the blood plasma proteolytic activity and the content of IL-1 beta, IL-6, IL-10. A clinical equivalent of the treatment efficacy is a rapid elimination of the signs of the pain and dyspeptic syndromes, the attainment and prolongation of the duration of clinic-endoscopic remission, an improvement of the quality of patients’ life. The results of the activity of the Chernivtsi Regional Clinical Hospital, the Storozhynets’ Central District Hospital (CDH) in the Chernivtsi region, the Transcarpatian Regional Clinical Hospital named after A. Novak, the Crimean republican institutions - "Clinical Hospital named M.O. Semashko”, Municipal Clinical Hospital № 2 of the City of Dnipropetrovs’k, Ternopil Municipal Communal Facility № 2, as well as into the scientific and educational activity of Bukovinian State Medical University, Ivano-Frankivs’k National Medical University, Crimean State Medical University named after of S.I. Georgiyevskyi, the Medical Faculty of Uzhhorod National University, L’viv National Medical University named after DanyloHalyts’kyi, Ternopil State Medical University named after I.Ya. Horbachevs’kyi. The field of application: gastroenterology, pulmonology, therapy, family medicine. Establishments of practical medicine: gastroenterologic, pulmonologic and therapeutic departments of hospitals and polyclinics.