Aukhadiev N. Pathogenic mechanisms of progression of lung insufficiency at associative flow of chronic purulent-destructive diseases of lungs and cirrhosis of liver and its correction

Object of study: 181 patients - 136 patients with pyo-destructive forms of chronic nonspecific pulmonary diseases (CNPD), 29 patients with liver cirrhosis and 16 patients with chronic heart failure. Objective: to study the level and functional activity of fibronectin, the state of endotoxic potential, justify and evaluate the effectiveness of correcting their violations methods in the complex treatment of purulent-destructive forms of CNPD in combination with liver cirrhosis. Methods: clinical, laboratory, immunological, biochemical. Theoretical and practical results: the features associated with cirrhosis of the liver disorders in the system of fibronectins and endotoxins of Escherichia coli, as well as immune imbalance in patients with purulent-destructive forms of CNPD are found. The lung disease in such patients is characterized by a significant violations of the content and functional activity of the fibronectin, Escherichia coli endotoxin and cytokines, a more pronounced imbalance of the bronchopulmonary system antiendotoxin immunity and of lymphocyte non-specific and inducible helper and suppressible activity. The clinical efficacy of fibronectin substitutional therapy (infusion of fresh frozen plasma with heparin and sodium bicarbonate) for correction the plasma fibronectin level and entero-sorption by hemosorbents carbonic DNA-containing bio-specific haemosorbent for system endotoxinemia correction in patients with purulent-destructive forms of CNPD in combination with liver cirrhosis is proved. Novelty: the fibronectin- and endotoxin-dependent mechanisms of pulmonary failure progression in patients with purulent-destructive forms of CNPD combined with subcompensated and decompensated liver cirrhosis are revealed. The advisability of the fibronectin and endotoxin level correction in patients with purulent-destructive forms of CNPD and the liver decompensated cirrhosis with gipofibronectinopenia and pathological endotoxinemia for improvement of the disease course is substantiated. Degree of implementation: articles, abstracts, materials, inclusion in the higher medical institutions educational process. Scope of use: medicine.