Teleki Y. The clinico-pathogenetic substantiation of diagnosis and treatment of chronic obstructive pulmonary disease patients with concomitant chronic pancreatitis

The object of the research: the clinical course, the components of chronic inflammatory reaction, the quality of life in patients with chronic obstructive pulmonary disease (COPD) with concomitant chronic pancreatitis (CP). Objective – to improve the diagnosis, to reduce the systemic manifestations of COPD and to improve quality of life of COPD patients with concomitant CP, to develop methods of pharmacological correction. Methods: clinical, biochemical, immunoenzymatic, filtration, instrumental, sociological and statistics. Novelty - basing on the study of chronic persistent markers of systemic inflammation in COPD patients with concomitant CP, the expediency of including essential phospholipids and quercetin in the treatment regimen has been demonstrated for the first time. Results: the close interrelation between cytokine balance, functional state of endothelium, metabolic and hemocoagulating haemostasis links and carbohydrate metabolism in patients with COPD with concomitant HP was proved that allowed establishing the features of the pathogenesis of combined course and confirming that comorbidity of these diseases is accompanied by development of chronic generalized inflammatory response. The inclusion of essential phospholipids to the complex treatment promoted elimination of cytokine imbalance, endothelial dysfunction, improved the morphofunctional properties of erythrocytes, the balance of proteolytic and fibrinolytic activity of blood plasma, and quality of life of patients. The addition of quercetin to the basic treatment of COPD with concomitant CP resulted in correction of oxidant-antioxidant homeostasis, plasma fibrinolytic activity. The above helps to better the clinical picture of combined diseases, functional state of bronchopulmonary system, pancreas and quality of life, prolongs remission. The results are put into practice in Chernivtsi Regional Hospital, Cherkassy Regional Hospital, the Transcarpatian Regional Clinical Hospital named after A. Novak, Ternopil Municipal Communal Facility № 2, the Crimean republican institutions - "Clinical Hospital named M.O. Semashko”, Vinnitsa Municipal Communal Facility № 2, as well as into the scientific and educational activity of Bukovinian State Medical University, Ternopil State Medical University named after I.Ya. Horbachevs’kyi, the Medical Faculty of Uzhhorod National University, Crimean State Medical University named after of S.I. Georgiyevskyi. The field of application: gastroenterology, pulmonology, therapy, family medicine. Establishments of practical medicine: gastroenterologic, pulmonologic and therapeutic departments of hospitals and polyclinics.