Titkova A. The optimization of diagnostics and treatment of chronic obstructive pulmonary disease with concomitant gastroesophageal reflux disease based on the assessment of ghrelin and the cytokine system.

The dissertation is devoted to the optimization of diagnostics and treatment of chronic obstructive pulmonary disease (COPD) with concomitant gastroesophageal reflux disease (GERD) based on the study of pathogenic role of ghrelin, the cytokine system in conjunction with the change in quality of life (QoL) parameters and characteristics of clinical and functional course of primary and related pathologies. The study involved 113 COPD patients, of which 69 patients had concomitant GERD and 44 patients were with isolated COPD and 25 healthy individuals in the control group. A statistically significant increase in the levels of ghrelin, interleukins (IL) 6 and 4, C-reactive protein at lower levels of the basic spirometry indicators in patients of both groups (more pronounced in COPD patients with concomitant GERD) was found. We have also discovered that the depth and the nature of the identified violations are in direct correlations with indicators of CAT-test and in back correlations - with the level indicators of QoL of SF-36 questionnaire, more pronounced in COPD patients with concomitant GERD. It was proved that the additional inclusion of proton pump inhibitors to the standard pattern of bronchodilatator therapy in COPD patients with concomitant GERD accelerates the onset of clinical remission, improves the basic spirometry indicators, promotes more rapid correction of cytokine disorders and the ghrelin level.